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The outcomes of quadriceps tendon autograft for anterior cruciate ligament reconstruction in adolescent athletes: a retrospective case series

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Abstract

Background

Multiple graft options exist for anterior cruciate ligament (ACL) reconstruction in an adolescent athlete. Patellar tendon harvest can lead to anterior knee pain, while hamstring tendon harvest can affect knee flexion strength and alter mechanics. Allograft is less desirable in pediatric patients due to the higher failure rate and slight risk of disease transmission. Quadriceps tendon autograft has rarely been reported for adolescent ACL reconstruction in the USA, but is an excellent option due to its large size, low donor site morbidity, and versatility. The purpose of this study is to report the outcomes of adolescents who have undergone ACL reconstruction using quadriceps tendon autograft.

Methods

Twenty-two ACL reconstructions using the quadriceps autograft were performed on 21 pediatric patients by the senior author between 2010 and 2017. The patient’s demographics, injury characteristics, imaging, physical examination findings, operative findings, outcomes and sports were recorded.

Results

The average age at the time of surgery was 15 years. Two patients had open physes; the remainder had closing physes. 64% of patients had additional meniscal tears and 76% had bony contusions. The average duration of follow-up was 2.8 years (range 2–5 years). At final follow-up, there were no angular deformities or leg length discrepancies. The average quadriceps atrophy of the operative leg was 4 mm. The average Lysholm score was 98. 86% of patients returned to sports. No patients had re-rupture of their operative ACL. No incidences of infections, numbness, or anterior knee pain were reported. Two patients had a second arthroscopy for re-injury, revealing new meniscal tears but intact ACL grafts.

Conclusions

Use of quadriceps tendon autograft for ACL reconstruction in adolescent patients allows reliable return to sport with minimal complications.

Level of evidence

Level IV, retrospective case series.

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Funding

The study received no funding to complete.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Wake Forest Medical Center, Watlington Hall, 4th Floor, 1 Medical Center Boulevard Winston Salem, Winston-Salem, NC, 27157, US

    Natalie H. Vaughn

  2. Department of Orthopaedics, Penn State Health Milton S. Hershey Medical Center, 500 University Dr., 414 Hallmark South, Hershey, PA, 17033, USA

    Mark L. Dunleavy & William Hennrikus

  3. Department of Orthopaedics, University of Colorado Anschutz Medical Campus, 12631 East 17th Avenue, 4602, Aurora, CO, 80045, US

    Trevor Jackson

Authors
  1. Natalie H. Vaughn
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  2. Mark L. Dunleavy
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  3. Trevor Jackson
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  4. William Hennrikus
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Contributions

NHV MD (Contribution: background research, data collection, manuscript preparation, editing), MLD MD (Contribution: background research, manuscript preparation, editing), TJ MD (Contribution: background research, data collection, manuscript preparation), and WH MD (Contribution: data collection, manuscript preparation, editing).

Corresponding author

Correspondence to Mark L. Dunleavy.

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Conflict of interest

The authors declare that they have no competing interests.

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Consent for publication was obtained from all patients in this study.

Availability of data and materials: The data will not be deposited because they include patients’ personal information.

Ethical approval

This study obtained the approval of our institutional ethical review board (Penn State College of Medicine Institutional Review Board) to complete.

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Vaughn, N.H., Dunleavy, M.L., Jackson, T. et al. The outcomes of quadriceps tendon autograft for anterior cruciate ligament reconstruction in adolescent athletes: a retrospective case series. Eur J Orthop Surg Traumatol 32, 739–744 (2022). https://doi.org/10.1007/s00590-021-03032-x

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  • DOI: https://doi.org/10.1007/s00590-021-03032-x

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