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ACL RECONSTRUCTION USING THE QUADRICEPS TENDON AUTOGRAFT : TWO YEAR FOLLOW-UP



Abstract

The middle third of quadriceps tendon is an autograft of sufficient size and strength and is stronger than the patellar tendon autograft with the same dimensions. We present the results from the use of a quadriceps autograft for the reconstruction of the chronically ACL deficient knee.

Between March 1999 and March 2000 we treated 36 patients with chronic ACL deficiency using a quadriceps tendon autograft, harvested from the middle third of the tendon with and without a patellar bone block.

The tendinous side of the graft was stabilized using the Mark II and Patella Soffix fixation systems (Surgicraft, UK). In the tibia the graft was passed through a tunnel and in the femur it was passed over the top. In those cases where the graft was harvested with a bone block, his was fixed to the tibia using interference screw fixation. The mean postoperative follow up was 21 months. The results have been evaluated using the IKDC, the Lysholm and the Tegner scales. According to the International Knee Documentation Committee rating system most of the patients had normal or nearly normal ratings. Knee laxity was evaluated using the arthrometers KT-2000 and Rolilmeter. There were no significant complications related to the harvesting site and there was no significant differences between the two groups regarding stability and function. MRI evaluation and second look arthroscopies in 7 patients revealed graft survival

The quadriceps tendon-patellar autograft is a reasonable alternative ACL reconstruction in primary and probably revision ACL reconstruction with minimal donor site morbidity and restoration of knee stability.

The abstracts were prepared by Mr Roger Smith. Correspondence should be addressed to him at the British Association for Surgery of the Knee, c/o BOA, Royal College of Surgeons of England, 35–43 Lincoln’s Inn Fields, London WC2A 3PN.