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Comparison of functional outcome between bone quadriceps tendon (BQT) and single-bundle hamstring tendon (SBHT) autograft in arthroscopic-assisted anterior cruciate ligament reconstruction cases: a prospective cohort study

Background: ACL rupture has a high morbidity in productive-age population. The increasing incidence and proper
management has become a point of interest in the musculoskeletal sport injury. Choosing the best graft has
become the main focus in searching for a better outcome regarding ACL reconstruction in these patient population. Currently, single bundle hamstring tendon (SBHT) autograft was preferred in Asian population compared to bone quadriceps tendon (BQT) autograft. However, there are some problems such as short and small in
diameter of SBHT. This study is focused on evaluation of the clinical outcome between BQT and SBHT in
arthroscopic-assisted ACL reconstruction patients. Materials and methods: In this prospective cohort study, 30 subjects were divided into 2 groups (BQT and SBHT). Sampling was taken between February 2017–2018 (1 year) in one orthopaedic center. The instruments used for evaluation are rolimeter and patient-reported outcome (PRO) questionnaires (IKDC, Tegner-Lysholm, and KOOS) with data mining between 3 months, 6 months, and 1 year post operation. This study has been reported in line with the STROCSS criteria.

Results: Mean difference of quadriceps (3.12 ± 0.94) and hamstring (3.87 ± 0.61) in rolimeter measurement 1
year post operation is statistically significant (p = 0.015). Side-to-side difference shows better result in quadriceps (0.34 ± 0.70) compared to hamstring (0.84 ± 0.60) with p value 0.04. IKDC scores in one month (p =
0.002; CI95% [8.81–31.79]) and three months (p = 0.004; CI95% [4.85–20.39]) post operative is better in
quadriceps group. Tegner-Lysholm assessment 1 month post operative showed consistent results between numeric
(p = 0.004) and categoric data (p = 0.050) in quadriceps group. There was an improvement during six months
and one year post operative KOOS sub-item scales; pain (p = 0.034) and symptoms (p = 0.001).
Conclusion: Functional outcome of patient undergoing arthroscopic-assisted ACL reconstruction is better in BQT
group compared to SBHT group, both in subjective and objective parameters given.


Andri MT Lubis, MD, PhD, Demy Faheem Dasril, MD
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