Udit Dave B.S. , Sione A. Ofa M.D. , Victoria K. Ierulli M.S. , Andre Perez-Chaumont M.D. , Mary K. Mulcahey M.D.
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Studies were included if they met the following criteria: randomized controlled trials that included patients who underwent ACL reconstruction with BPTB or quadriceps tendon autograft including all soft tissue and bone–quadriceps tendon and in which measures of postoperative stability and functional outcomes were reported. Studies that were not written in English and those that analyzed animals or cadavers, were not randomized controlled trials, or used other grafts (e.g., hamstring) were excluded.</p></div><div><h3>Results</h3><p>The initial search identified 348 studies, 6 of which were included in this systematic review. Two of the six studies found no significant difference in performance outcomes or complications between quadriceps and BPTB autografts. One study found that patients receiving quadriceps autograft self-reported improved knee functional status compared with those receiving BPTB autograft. Another study found that quadriceps autograft resulted in a significantly reduced Quadriceps Index postoperatively compared with BPTB autograft (69.5 vs 82.8, <em>P</em> = .01) but found no difference in postoperative quadriceps strength. An additional study found that the outcomes of quadriceps tendon and BPTB autografts were equivalent per the International Knee Documentation Committee scale, but anterior knee pain was less severe in patients with quadriceps tendon autograft. Furthermore, one study revealed the overall International Knee Documentation Committee score was reported as normal significantly more often in patients who underwent ACL reconstruction with BPTB autograft (85% vs 50%, <em>P</em> < .001) and that donor-site morbidity was greater in patients with quadriceps autograft. No significant difference was found in complications requiring reoperation across studies.</p></div><div><h3>Conclusions</h3><p>Patients undergoing ACL reconstruction with either BPTB or quadriceps tendon autograft reported improved postoperative knee stability and functional outcomes. There is no significant difference in complications between quadriceps autograft use and BPTB autograft use.</p></div><div><h3>Level of Evidence</h3><p>Level III, systematic review of Level III retrospective studies.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000373/pdfft?md5=015db8cfafd67a66342f1c3b75471b3d&pid=1-s2.0-S2666061X24000373-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Both Quadriceps and Bone–Patellar Tendon–Bone Autografts Improve Postoperative Stability and Functional Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review\",\"authors\":\"Udit Dave B.S. , Sione A. Ofa M.D. , Victoria K. Ierulli M.S. , Andre Perez-Chaumont M.D. , Mary K. 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Studies that were not written in English and those that analyzed animals or cadavers, were not randomized controlled trials, or used other grafts (e.g., hamstring) were excluded.</p></div><div><h3>Results</h3><p>The initial search identified 348 studies, 6 of which were included in this systematic review. Two of the six studies found no significant difference in performance outcomes or complications between quadriceps and BPTB autografts. One study found that patients receiving quadriceps autograft self-reported improved knee functional status compared with those receiving BPTB autograft. Another study found that quadriceps autograft resulted in a significantly reduced Quadriceps Index postoperatively compared with BPTB autograft (69.5 vs 82.8, <em>P</em> = .01) but found no difference in postoperative quadriceps strength. 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引用次数: 0
摘要
目的比较使用骨-髌腱-骨(BPTB)与股四头肌腱自体移植物进行前交叉韧带(ACL)重建术后的膝关节稳定性、功能预后和并发症。方法根据PRISMA(系统综述和Meta分析首选报告项目)指南,检索PubMed、Embase和Cochrane图书馆数据库中2002年或之后发表的研究。符合以下标准的研究均被纳入其中:随机对照试验,这些试验纳入了接受 BPTB 或股四头肌腱自体移植(包括所有软组织和骨-股四头肌腱)的前交叉韧带重建术的患者,并报告了术后稳定性和功能结果的测量指标。非英语撰写的研究、分析动物或尸体的研究、非随机对照试验的研究或使用其他移植物(如腘绳肌)的研究均被排除在外。在这 6 项研究中,有 2 项研究发现股四头肌自体移植物和 BPTB 自体移植物在性能结果或并发症方面没有明显差异。一项研究发现,与接受 BPTB 自体移植物的患者相比,接受股四头肌自体移植物的患者自我报告的膝关节功能状况有所改善。另一项研究发现,股四头肌自体移植与 BPTB 自体移植相比,术后股四头肌指数显著降低(69.5 vs 82.8,P = .01),但在术后股四头肌力量方面没有发现差异。另一项研究发现,根据国际膝关节文献委员会的量表,股四头肌肌腱自体移植和 BPTB 自体移植的疗效相当,但股四头肌肌腱自体移植患者的膝关节前部疼痛较轻。此外,一项研究显示,使用 BPTB 自体移植物进行前交叉韧带重建的患者中,国际膝关节文献委员会总体评分报告为正常的比例明显更高(85% vs 50%, P <.001),而且使用股四头肌自体移植物的患者供体部位发病率更高。结论接受 BPTB 或股四头肌肌腱自体移植前交叉韧带重建术的患者术后膝关节稳定性和功能结果均有所改善。使用股四头肌自体移植物和使用 BPTB 自体移植物在并发症方面没有明显差异。
Both Quadriceps and Bone–Patellar Tendon–Bone Autografts Improve Postoperative Stability and Functional Outcomes After Anterior Cruciate Ligament Reconstruction: A Systematic Review
Purpose
To compare postoperative knee stability, functional outcomes, and complications after anterior cruciate ligament (ACL) reconstruction using bone–patellar tendon–bone (BPTB) versus quadriceps tendon autograft.
Methods
In accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, the PubMed, Embase, and Cochrane Library databases were searched for studies published in 2002 or later. Studies were included if they met the following criteria: randomized controlled trials that included patients who underwent ACL reconstruction with BPTB or quadriceps tendon autograft including all soft tissue and bone–quadriceps tendon and in which measures of postoperative stability and functional outcomes were reported. Studies that were not written in English and those that analyzed animals or cadavers, were not randomized controlled trials, or used other grafts (e.g., hamstring) were excluded.
Results
The initial search identified 348 studies, 6 of which were included in this systematic review. Two of the six studies found no significant difference in performance outcomes or complications between quadriceps and BPTB autografts. One study found that patients receiving quadriceps autograft self-reported improved knee functional status compared with those receiving BPTB autograft. Another study found that quadriceps autograft resulted in a significantly reduced Quadriceps Index postoperatively compared with BPTB autograft (69.5 vs 82.8, P = .01) but found no difference in postoperative quadriceps strength. An additional study found that the outcomes of quadriceps tendon and BPTB autografts were equivalent per the International Knee Documentation Committee scale, but anterior knee pain was less severe in patients with quadriceps tendon autograft. Furthermore, one study revealed the overall International Knee Documentation Committee score was reported as normal significantly more often in patients who underwent ACL reconstruction with BPTB autograft (85% vs 50%, P < .001) and that donor-site morbidity was greater in patients with quadriceps autograft. No significant difference was found in complications requiring reoperation across studies.
Conclusions
Patients undergoing ACL reconstruction with either BPTB or quadriceps tendon autograft reported improved postoperative knee stability and functional outcomes. There is no significant difference in complications between quadriceps autograft use and BPTB autograft use.
Level of Evidence
Level III, systematic review of Level III retrospective studies.