ACL injuries are ubiquitous and the literature surrounding ACL reconstructions is complex and difficult to comprehend. In summary, this paper provides a simple yet coherent overview of ACL injuries. Etiology, prevention, and the consequences of injury are discussed. The paper examines literature surrounding the decision to reconstruct the anterior cruciate ligament. An overwhelming quantity of literature is in favor of an ACL reconstruction in order to maintain an active lifestyle. ACL surgery has advanced exponentially in recent years and there is a multitude of fixation and tunneling methods.
Graft choice for an ACL reconstruction is also complicated and multifactorial. In general, three types of grafts exist: autografts, allografts, and synthetic grafts. Autografts usually include the hamstring tendon (HT) and patella tendon (BTB), however, recent studies suggest the quadricep tendon (QT) may be a suitable graft. The BTB is often considered the “gold standard” due to its strength and stability. On the other hand, the HT is often used as it is less invasive and is associated with less antero-patellar knee pain. Common allografts include the patella tendon, Achilles tendon, and tibialis muscle group. Despite a higher cost, allografts are usually used in revision surgeries and leave patients with less donor-site morbidity. Lastly, synthetic grafts are growing in popularity, especially the LARS procedure, however, more research is needed.
Lastly, this paper attempts to consolidate literature surrounding the QT graft. Only one meta-analysis focusing on the QT has been published, however, the last meta-analysis is from three years ago and several new studies have been published since. The recent literature suggests the QT is a viable option in terms of stability and functional outcomes. Specifically, when comparing the QT to BTB and HT, the QT grades similarity in KT-1000 scores, a common measure of knee laxity and stability. Additionally, IKDC scores, frequently used to assess functionality, show positive results. More literature is needed to fully understand the QT; however, preliminary research indicates the QT can be an esteemed option in ACL reconstruction surgery.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/32979 |
| Date | 24 October 2018 |
| Creators | Green, Bradley |
| Contributors | Franzblau, Carl, Offner, Gwynneth |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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