Quadriceps tendon autograft for primary ACL reconstruction: a Bayesian network meta-analysis

European Journal of Orthopaedic Surgery & Traumatology, vol. 30, pp. 1129–1138

Abstract

BACKGROUND: The purpose of the current study was to clarify the role of the quadriceps tendon (QT) autograft for primary ACL reconstruction. Thus, a Bayesian network meta-analysis comparing patients undergoing a primary ACL reconstruction with QT versus patellar tendon (PT) and hamstring tendon (HT) autografts was conducted. MATERIAL AND METHODS: This Bayesian network meta-analysis was conducted according to the PRISMA extension statement for reporting systematic reviews incorporating network meta-analyses of health care interventions. In January 2020, the main databases were accessed. Articles comparing the outcomes of the QT autograft versus HT autograft and/or PT autograft for primary ACL reconstruction were included in the present study. The statistical analysis was performed with STATA Software/MP, through a Bayesian hierarchical random-effect model analysis. RESULTS: Data from a total of 2603 knees were analysed. The overall mean follow-up was 35.0 months. Among the different grafts were evidenced comparable values of IKDC, Tegner and Lysholm score. The QT autograft detected comparable rate of Lachman test > 3 mm, Pivot shift test > 3 m and instrumental laxity > 3 mm. The QT autograft showed a lower rate of autograft failure above all. The QT autograft detected the reduced rate of AKP than the PT. CONCLUSION: Quadriceps tendon autograft may represent a feasible option for primary ACL reconstruction. These results must be interpret within the limitations of the present network meta-anlaysis.

Authors 6

1. Filippo Migliorini corresponding Aachen Department of Orthopaedics

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Orthopaedics, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany. migliorini.md@gmail.com

   Department of Orthopaedics, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

2. Jörg Eschweiler Aachen Department of Orthopaedics

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Orthopaedics, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

3. Yasser El Mansy Aachen Department of Orthopaedics

   RWTH Aachen University · Universitätsklinikum Aachen · Alexandria University

   Affiliation as printed

   Department of Orthopaedics, University Clinic of Alexandria, Alexandria, Egypt

   Department of Orthopaedics, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

4. Valentin Michael Quack Aachen Department of Orthopaedics

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Orthopaedics, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

5. Markus Tingart Aachen Department of Orthopaedics

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Orthopaedics, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany

6. Arne Driessen Aachen Department of Orthopaedics

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   Department of Orthopaedics, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany