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Anterior cruciate ligament injuries are one of the most common sports knee injuries. Their effect on the knee joint can be detrimental with patients experiencing instability and progressive damage of the intraarticular structures. Therefore, anterior cruciate ligament reconstruction (ACLR) is often indicated. Multiple graft option exist, including autograft, allograft and xenograft tissues, with autografts being considered as a first-choice source of reconstructed ligament in most cases. Two most common harvested autografts are hamstring tendons (semitendinosus or semitendinosus and gracilis tendons; ST or STG) and patellar tendon with two bone blocks (bone - patellar tendon - bone; BPTB). However, in the recent literature there is an increasing trend towards use of quadriceps tendon autograft (QT). Multiple techniques of harvesting this graft were described, including both partial and complete thickness of the tendon. Another issue is whether bone block from the upper pole of the patella is harvested along with the soft tissues (quadriceps tendon bone graft, QTB).
The aim of this study is to add to the body of knowledge concerning full-thickness quadriceps tendon-bone autograft (QTB) used in ACLR. The primary outcome consists of The International Knee Documentation Committee Questionnaire (IKDC), the Knee injury and Osteoarthritis Outcome Score (KOOS) and retear rate.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Main arm of the study | Experimental | Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon bone autograft (QTB) will be performed in these patients. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon bone autograft (QTB) | Procedure | Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon bone autograft (QTB) will be performed in these patients. QTB autografts will be harvested as described in the published technique: K. Malinowski, J. Paszkowski, M. Mostowy, A. Góralczyk, R.F. LaPrade, K. Hermanowicz, Quadriceps Tendon-Bone Full-Thickness Autograft: Reproducible and Easy Harvesting Technique Using Simple Surgical Tools, Arthrosc. Tech. 10 (2021) e1165-e1172. https://doi.org/10.1016/j.eats.2021.01.003. ACLR will be performed utilizing anteromedial technique with management of any accompanying intraarticular lesions. |
| Measure | Description | Time Frame |
|---|---|---|
| Knee stability | Anterior and anterolateral rotatory knee stability assessed by the means of instrumented Lachman test and pivot-shift test. | At the 12 month of the follow-up. |
| Knee stability | Anterior and anterolateral rotatory knee stability assessed by the means of instrumented Lachman test and pivot-shift test. | At the 24 month of the follow-up. |
| Measure | Description | Time Frame |
|---|---|---|
| The functional assessment with the The International Knee Documentation Committee Questionnaire (IKDC) | Min of 0 max of 87 points, higher scores mean a better outcome | At the 12 month of the follow-up. |
| The functional assessment with the The International Knee Documentation Committee Questionnaire (IKDC) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Konrad Malinowski, MD PhD | Contact | +48 509812212 | malwin8@wp.pl |
| Name | Affiliation | Role |
|---|---|---|
| Konrad Malinowski, MD PhD | Artromedical Orthopaedic Clinic, Bełchatów, Poland | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Artromedical Orthopaedic Clinic | Recruiting | Bełchatów | Łódź Voivodeship | 97-400 | Poland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33981566 | Background | Malinowski K, Paszkowski J, Mostowy M, Goralczyk A, LaPrade RF, Hermanowicz K. Quadriceps Tendon-Bone Full-Thickness Autograft: Reproducible and Easy Harvesting Technique Using Simple Surgical Tools. Arthrosc Tech. 2021 Mar 18;10(4):e1165-e1172. doi: 10.1016/j.eats.2021.01.003. eCollection 2021 Apr. | |
| 31704697 | Background |
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Single Group: Clinical trials with a single arm.
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|
Min of 0 max of 87 points, higher scores mean a better outcome |
| At the 24 month of the follow-up. |
| The functional assessment with the Knee injury and Osteoarthritis Outcome Score | Min of 0 max of 100 points, higher scores mean a better outcome | At the 12 month of the follow-up. |
| The functional assessment with the Knee injury and Osteoarthritis Outcome Score | Min of 0 max of 100 points, higher scores mean a better outcome | At the 24 month of the follow-up. |
| Retear rate | Rate of patients with retear of the reconstructed ligament | At the 12 month of the follow-up. |
| Retear rate | Rate of patients with retear of the reconstructed ligament | At the 24 month of the follow-up. |
| ROM | Knee range of motion assessed by the means of goniometer. | At the 12 month of the follow-up. |
| ROM | Knee range of motion assessed by the means of goniometer. | At the 24 month of the follow-up. |
| Lind M, Nielsen TG, Soerensen OG, Mygind-Klavsen B, Fauno P. Quadriceps tendon grafts does not cause patients to have inferior subjective outcome after anterior cruciate ligament (ACL) reconstruction than do hamstring grafts: a 2-year prospective randomised controlled trial. Br J Sports Med. 2020 Feb;54(3):183-187. doi: 10.1136/bjsports-2019-101000. Epub 2019 Nov 8. |
| 25543249 | Background | Slone HS, Romine SE, Premkumar A, Xerogeanes JW. Quadriceps tendon autograft for anterior cruciate ligament reconstruction: a comprehensive review of current literature and systematic review of clinical results. Arthroscopy. 2015 Mar;31(3):541-54. doi: 10.1016/j.arthro.2014.11.010. Epub 2014 Dec 25. |
| 31305357 | Background | Mehran N, Damodar D, Shu Yang J. Quadriceps Tendon Autograft in Anterior Cruciate Ligament Reconstruction. J Am Acad Orthop Surg. 2020 Jan 15;28(2):45-52. doi: 10.5435/JAAOS-D-19-00032. |
| 24630956 | Background | Lund B, Nielsen T, Fauno P, Christiansen SE, Lind M. Is quadriceps tendon a better graft choice than patellar tendon? a prospective randomized study. Arthroscopy. 2014 May;30(5):593-8. doi: 10.1016/j.arthro.2014.01.012. Epub 2014 Mar 14. |
| ID | Term |
|---|---|
| D000070598 | Anterior Cruciate Ligament Injuries |
| ID | Term |
|---|---|
| D007718 | Knee Injuries |
| D007869 | Leg Injuries |
| D014947 | Wounds and Injuries |
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