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

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Sports medicine

Background:

• Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure.
• Graft choice significantly impacts patient outcomes.
• The quadriceps tendon (QT) is an emerging autograft option.

Purpose of the Study:

• To compare the efficacy of quadriceps tendon (QT) autografts against patellar tendon (PT) and hamstring tendon (HT) autografts for primary ACL reconstruction.
• To clarify the role of QT autografts in ACL surgery.

Main Methods:

• A Bayesian network meta-analysis was performed.
• Included studies compared QT autografts with PT and/or HT autografts for primary ACL reconstruction.
• Data from 2603 knees were analyzed using a Bayesian hierarchical random-effect model.

Main Results:

• Comparable IKDC, Tegner, and Lysholm scores were observed across all graft types.
• Similar rates of positive Lachman and Pivot shift tests, and instrumental laxity were found.
• The QT autograft demonstrated a lower rate of autograft failure and reduced anterior knee pain (AKP) compared to the PT autograft.

Conclusions:

• Quadriceps tendon autograft is a feasible option for primary ACL reconstruction.
• QT autografts show promising results, particularly regarding lower failure rates and reduced AKP.
• Further interpretation should consider the limitations inherent in this network meta-analysis.