High Return to Activity and Low Rerupture Rates Following All-Inside Quadriceps Tendon Anterior Cruciate Ligament Reconstruction With Bone Marrow Aspirate, Demineralized Bone Matrix, and Suture Tape Augmentation.

PURPOSE: To evaluate clinical outcomes of anterior cruciate ligament reconstruction (ACLR) using a quadriceps tendon autograft (QTA) with adjunctive bone marrow aspirate concentrate, demineralized bone matrix, and suture tape augmentation.

METHODS

A retrospective review was conducted using a prospectively maintained registry of patients who underwent all-inside ACLR with QTA, adjunctive bone marrow aspirate concentrate, demineralized bone matrix, and suture tape augmentation between July 2018 and October 2022 at a single institution. Patients with less than a 2-year follow-up were excluded. A telephone survey assessed return to preinjury activity level, and patient-reported outcomes were collected, including the International Knee Documentation Committee subjective score, ACL Return to Sport after Injury score, and Visual Analog Scale for pain. Complications such as graft rerupture and total reoperations were also recorded.

RESULTS

One hundred twenty patients (81%) received QTA ACLR, with 98 (81.7%) completing ≥2-year follow-up (37 female, 61 male; mean age 19.4 years, range 15-32). Mean follow-up was 3.4 years (range, 2.0-5.9). All patients were cleared for full activity at 6 months postoperatively. At the time of telephone follow-up, 90 patients (91.8%) reported they had returned to their preinjury activity levels. In all 98 patients, mean International Knee Documentation Committee and ACL Return to Sport after Injury scores were 84.0 ± 7.3 and 93.4 ± 17.2, respectively. There were 3 graft reruptures (3.1%) and 9 contralateral ACL tears (9.2%).

CONCLUSIONS

All-inside ACLR with QTA, adjunctive bone marrow aspirate concentrate, demineralized bone matrix, and suture tape augmentation showed high rates of return to preinjury activity and low graft rerupture rates at a minimum of 2 years of follow-up.

LEVEL OF EVIDENCE: Level IV, retrospective therapeutic case series.