Anterior Cruciate Ligament Reconstruction: Autogenous Quadriceps Tendon–Bone Compared With Bone–Patellar Tendon–Bone Grafts at 2-Year Follow-up

PurposeThe purpose of this study was to evaluate and compare postoperative anterior knee pain, knee stability, and functional scores of an autogenous bone–patellar tendon–bone (BPTB) graft and a quadriceps tendon–bone (QTB) graft.MethodsA total of 48 patients—27 who had anterior cruciate ligament (ACL) reconstruction by use of an autogenous BPTB graft and 21 who had ACL reconstruction by use of a QTB graft—were assessed at a minimum follow-up of 24 months after surgery. An accelerated rehabilitation program was adapted, and the rehabilitation protocol was identical for both groups.ResultsThe mean side-to-side difference as measured with a KT-2000 arthrometer (MEDmetric, San Diego, CA) was 2.73 mm (SD, 1.45 mm) in the BPTB group and 2.79 mm (SD, 1.32 mm) in the QTB group (P = .880). Postoperatively, the International Knee Documentation Committee score was grade A or B in 23 patients (85.2%) in the BPTB group and 18 (85.7%) in the QTB group (P = .997). The mean anterior knee pain score was 86.9 in the BPTB group as compared with 90.2 in the QTB group (P = .107). In a kneeling posture, 13 BPTB patients reported discomfort (moderate in 10 and severe in 3) whereas only 4 QTB patients had moderate discomfort (P = .029). No significant differences were found with regard to other activities surveyed.ConclusionsA QTB graft attached with the EndoPearl device (Linvatec, Largo, FL) appears to be an effective alternative for single-bundle ACL reconstruction. When followed with an accelerated rehabilitation program, reconstruction with a QTB graft provided knee stability comparable to a BPTB graft but with less kneeling pain than a BPTB graft.Level of EvidenceLevel III, retrospective comparative study.