Short-term patient-reported outcomes following rectus femoris versus quadriceps tendon and hamstring tendon autografts for ACL reconstruction with concomitant anterolateral procedure: A prospective comparative study.

PURPOSE: To compare short-term patient-reported outcomes following anterior cruciate ligament reconstruction (ACLR) with concomitant anterolateral procedure, using rectus femoris (RF), quadriceps tendon (QT) and hamstring tendons (HS) autografts. It was hypothesized that short-term patient-reported outcomes would not differ significantly across graft strategies at 1-year follow-up.

METHODS

A prospective comparative non-randomized study was conducted, including 90 consecutive patients undergoing primary ACLR between May 2022 and June 2023 (30 per group). Outcomes were assessed at a median follow-up of 15.0 months (range: 12-22) using the Knee injury and Osteoarthritis Outcome Score (KOOS) Pain and Quality of Life (QoL) subscales, EuroQOL 5-dimensions 5-level index (EQ-5D-5L), global satisfaction (0-100) and the Patient and Observer Scar Assessment Scale (POSAS). Continuous variables were compared using one-way analysis of variance with Bonferroni-corrected post hoc comparisons and categorical variables using χ 2 tests. A multivariable logistic regression model was used to assess predictors of POSAS ≤ 20.

RESULTS

Of the 90 consecutive patients initially included, one patient in the RF group was excluded following graft failure and revision surgery prior to outcome assessment, leaving 89 patients available for analysis. Mean global satisfaction was 86.5 ± 10.9, KOOS Pain 89.1 ± 13.2, KOOS QoL 71.4 ± 22.2 and EQ-5D-5L Index 0.85 ± 0.15. No statistically significant differences were observed between graft types in KOOS QoL (p = 0.344), KOOS Pain (p = 0.716), EQ-5D-5L (p = 0.386) or POSAS (p = 0.748). Global satisfaction did not differ significantly across graft groups (p = 0.074).

CONCLUSION

No statistically significant differences in short-term patient-reported outcomes were observed among RF, QT and HS autografts at 1-year follow-up. Graft strategy was not associated with differences in short-term postoperative patient-reported outcomes within the available sample.

LEVEL OF EVIDENCE: Level III.