Comparison of Functional Outcome Between BQT and SBHT ACL Reconstruction

NCT04536246 | Completed

• 1 other identifier: BQT-SBHT-FMUI
• Study Type: interventional
• Target: 30
• Locations: 0 countries
• Sites: N/A

Brief Summary

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 smaller size, as well as diameter, of SBHT. This study is focused on evaluation of the clinical outcome between BQT and SBHT in arthroscopic-assisted ACL reconstruction patients.

Conditions

Sports Injury; Anterior Cruciate Ligament Rupture

Keywords

ACL reconstruction; Arthroscopic-assisted; BQT; SBHT

Outcome Measures

Primary Outcomes (2)

• Changes (Improvement) of Rolimeter Measurement After Procedure

  1. Rolimeter measurement is the objective outcome expected in this study 2. This device was calibrated and tested prior to the usage in the study 3. Literature review --\> no significant difference between KT1000/2000 and rolimeter for measuring antero-posterior translation of the knee joint

  Measurement in 1 year after operation

• Changes (Improvement) of PRO Questionnaire After Procedure

  1. We use three different PRO to make an accountable subjective outcome 2. No standard PRO questionnaire for ACL cases; we used three to be able to triangulate the mean subjective outcome 3. Rationale for using three PRO : these PROs were rapidly used in other similar studies around the world, had good and reliable results, and contains categoric and numeric data for statistical computation and interpretation

  PRO was taken in a period of 1 year after surgical procedure

Study Arms (2)

BQT Group

ACTIVE COMPARATOR

Procedure on this arm = bone quadriceps tendon reconstruction

Procedure: Bone Quadriceps Tendon (BQT) arthroscopic-assisted ACL reconstruction

SBHT Group

OTHER

Procedure on this arm = single-bundle hamstring tendon reconstruction

Procedure: Single-Bundle Hamstring Tendon (SBHT) arthroscopic-assisted ACL reconstruction

Interventions

Bone Quadriceps Tendon (BQT) arthroscopic-assisted ACL reconstruction PROCEDURE

New intervention method deployed in Indonesia to gain better clinical outcome for ACL--deficient patients requiring surgical treatment

BQT Group

Single-Bundle Hamstring Tendon (SBHT) arthroscopic-assisted ACL reconstruction PROCEDURE

Comparator for New Reconstruction Technique

SBHT Group

Eligibility Criteria

• Age: 15 Years - 40 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Unilateral, total rupture of ACL
• Procedure performed by the same surgeon
• Age of subjects between 15-40 years old

You may not qualify if:

• Multiligamentous injury
• Bilateral ACL ruptures
• Ligamentous laxity
• Prior knee ligamentous surgery

Sponsors & Collaborators

• Indonesia University: lead

Related Publications (26)

• Cavaignac E, Coulin B, Tscholl P, Nik Mohd Fatmy N, Duthon V, Menetrey J. Is Quadriceps Tendon Autograft a Better Choice Than Hamstring Autograft for Anterior Cruciate Ligament Reconstruction? A Comparative Study With a Mean Follow-up of 3.6 Years. Am J Sports Med. 2017 May;45(6):1326-1332. doi: 10.1177/0363546516688665. Epub 2017 Mar 8.

  PMID: 28273424 BACKGROUND

• Lee JK, Lee S, Lee MC. Outcomes of Anatomic Anterior Cruciate Ligament Reconstruction: Bone-Quadriceps Tendon Graft Versus Double-Bundle Hamstring Tendon Graft. Am J Sports Med. 2016 Sep;44(9):2323-9. doi: 10.1177/0363546516650666. Epub 2016 Jun 30.

  PMID: 27365373 BACKGROUND

• Haner M, Bierke S, Petersen W. Anterior Cruciate Ligament Revision Surgery: Ipsilateral Quadriceps Versus Contralateral Semitendinosus-Gracilis Autografts. Arthroscopy. 2016 Nov;32(11):2308-2317. doi: 10.1016/j.arthro.2016.03.020. Epub 2016 May 18.

  PMID: 27209621 BACKGROUND

• Akoto R, Hoeher J. Anterior cruciate ligament (ACL) reconstruction with quadriceps tendon autograft and press-fit fixation using an anteromedial portal technique. BMC Musculoskelet Disord. 2012 Aug 27;13:161. doi: 10.1186/1471-2474-13-161.

  PMID: 22925587 BACKGROUND

• Yue B, Varadarajan KM, Ai S, Tang T, Rubash HE, Li G. Differences of knee anthropometry between Chinese and white men and women. J Arthroplasty. 2011 Jan;26(1):124-30. doi: 10.1016/j.arth.2009.11.020. Epub 2010 Feb 9.

  PMID: 20149574 BACKGROUND

• Zaffagnini S, Marcacci M, Lo Presti M, Giordano G, Iacono F, Neri MP. Prospective and randomized evaluation of ACL reconstruction with three techniques: a clinical and radiographic evaluation at 5 years follow-up. Knee Surg Sports Traumatol Arthrosc. 2006 Nov;14(11):1060-9. doi: 10.1007/s00167-006-0130-x. Epub 2006 Aug 15.

  PMID: 16909301 BACKGROUND

• Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11(0 11):S208-28. doi: 10.1002/acr.20632. No abstract available.

  PMID: 22588746 BACKGROUND

• Bekkers JE, de Windt TS, Raijmakers NJ, Dhert WJ, Saris DB. Validation of the Knee Injury and Osteoarthritis Outcome Score (KOOS) for the treatment of focal cartilage lesions. Osteoarthritis Cartilage. 2009 Nov;17(11):1434-9. doi: 10.1016/j.joca.2009.04.019. Epub 2009 May 7.

  PMID: 19454278 BACKGROUND

• Schulz AP, Lange V, Gille J, Voigt C, Frohlich S, Stuhr M, Jurgens C. Anterior cruciate ligament reconstruction using bone plug-free quadriceps tendon autograft: intermediate-term clinical outcome after 24-36 months. Open Access J Sports Med. 2013 Nov 19;4:243-9. doi: 10.2147/OAJSM.S49223. eCollection 2013.

  PMID: 24379730 BACKGROUND

• Mologne T, Friedman M. Arthroscopic anterior cruciate reconstruction with hamstring tendons: indications, surgical technique, and complications and their treatment. In: Insall & Scott Surgery of the Knee. 4th ed. Philadelphia: Elsevier Inc; 2006.

  BACKGROUND

• Chen V, Hunter R, Woolf J. Anterior Cruciate Ligament Injuries. In: Schepsis A, Busconi B, editors. Orthopaedic Surgery Essential - Sports Medicine. Philadelphia: Lippincott Williams & Wilkins; 2006.

  BACKGROUND

• Pavlovich R Jr, Goldberg SH, Bach BR Jr. Adolescent ACL injury: treatment considerations. J Knee Surg. 2004 Apr;17(2):79-93. doi: 10.1055/s-0030-1248203.

  PMID: 15124660 BACKGROUND

• Lyman S, Koulouvaris P, Sherman S, Do H, Mandl LA, Marx RG. Epidemiology of anterior cruciate ligament reconstruction: trends, readmissions, and subsequent knee surgery. J Bone Joint Surg Am. 2009 Oct;91(10):2321-8. doi: 10.2106/JBJS.H.00539.

  PMID: 19797565 BACKGROUND

• Shi DL, Yao ZJ. Knee function after anterior cruciate ligament reconstruction with patellar or hamstring tendon: a meta-analysis. Chin Med J (Engl). 2011 Dec;124(23):4056-62.

  PMID: 22340342 BACKGROUND

• Peter Layde SLC, Layde P, Guse CE, Schlotthauer AE, Valin SE Van. The Incidence and Etiology of Anterior Cruciate Ligament Injuries in Patients under the Age of 18 in the State of Wisconsin. Pediatr Ther [Internet]. 2014;04(02). Available from: https://www.omicsonline.org/open-access/the-incidence-and-etiology-of-anterior-cruciate-ligament-injuries-in-patients-under-the-age-of-in-the-state-of-wisconsin-2161-0665.1000196.php?aid=26065

  BACKGROUND

• Collins JE, Katz JN, Donnell-Fink LA, Martin SD, Losina E. Cumulative incidence of ACL reconstruction after ACL injury in adults: role of age, sex, and race. Am J Sports Med. 2013 Mar;41(3):544-9. doi: 10.1177/0363546512472042. Epub 2013 Jan 9.

  PMID: 23302260 BACKGROUND

• Tow BP, Chang PC, Mitra AK, Tay BK, Wong MC. Comparing 2-year outcomes of anterior cruciate ligament reconstruction using either patella-tendon or semitendinosus-tendon autografts: a non-randomised prospective study. J Orthop Surg (Hong Kong). 2005 Aug;13(2):139-46. doi: 10.1177/230949900501300206.

  PMID: 16131675 BACKGROUND

• Deehan DJ, Salmon LJ, Webb VJ, Davies A, Pinczewski LA. Endoscopic reconstruction of the anterior cruciate ligament with an ipsilateral patellar tendon autograft. A prospective longitudinal five-year study. J Bone Joint Surg Br. 2000 Sep;82(7):984-91. doi: 10.1302/0301-620x.82b7.10573.

  PMID: 11041586 BACKGROUND

• Panni AS, Milano G, Tartarone M, Demontis A, Fabbriciani C. Clinical and radiographic results of ACL reconstruction: a 5- to 7-year follow-up study of outside-in versus inside-out reconstruction techniques. Knee Surg Sports Traumatol Arthrosc. 2001;9(2):77-85. doi: 10.1007/s001670000171.

  PMID: 11354857 BACKGROUND

• Dargel J, Schmidt-Wiethoff R, Schneider T, Bruggemann GP, Koebke J. Biomechanical testing of quadriceps tendon-patellar bone grafts: an alternative graft source for press-fit anterior cruciate ligament reconstruction? Arch Orthop Trauma Surg. 2006 May;126(4):265-70. doi: 10.1007/s00402-005-0048-7. Epub 2005 Sep 17.

  PMID: 16172862 BACKGROUND

• Staeubli HU, Bollmann C, Kreutz R, Becker W, Rauschning W. Quantification of intact quadriceps tendon, quadriceps tendon insertion, and suprapatellar fat pad: MR arthrography, anatomy, and cryosections in the sagittal plane. AJR Am J Roentgenol. 1999 Sep;173(3):691-8. doi: 10.2214/ajr.173.3.10470905.

  PMID: 10470905 BACKGROUND

• Lee S, Seong SC, Jo H, Park YK, Lee MC. Outcome of anterior cruciate ligament reconstruction using quadriceps tendon autograft. Arthroscopy. 2004 Oct;20(8):795-802. doi: 10.1016/j.arthro.2004.06.009.

  PMID: 15483539 BACKGROUND

• Beynnon BD, Johnson RJ, Abate JA, Fleming BC, Nichols CE. Treatment of anterior cruciate ligament injuries, part 2. Am J Sports Med. 2005 Nov;33(11):1751-67. doi: 10.1177/0363546505279922.

  PMID: 16230470 BACKGROUND

• Sofu H, Sahin V, Gursu S, Yildirim T, Issin A, Ordueri M. Use of quadriceps tendon versus hamstring tendon autograft for arthroscopic anterior cruciate ligament reconstruction: a comparative analysis of clinical results. Eklem Hastalik Cerrahisi. 2013;24(3):139-43. doi: 10.5606/ehc.2013.31.

  PMID: 24191878 BACKGROUND

• van Eck CF, Kropf EJ, Romanowski JR, Lesniak BP, Tranovich MJ, van Dijk CN, Fu FH. Factors that influence the intra-articular rupture pattern of the ACL graft following single-bundle reconstruction. Knee Surg Sports Traumatol Arthrosc. 2011 Aug;19(8):1243-8. doi: 10.1007/s00167-011-1427-y. Epub 2011 Feb 11.

  PMID: 21311861 BACKGROUND

• Ramski DE, Kanj WW, Franklin CC, Baldwin KD, Ganley TJ. Anterior cruciate ligament tears in children and adolescents: a meta-analysis of nonoperative versus operative treatment. Am J Sports Med. 2014 Nov;42(11):2769-76. doi: 10.1177/0363546513510889. Epub 2013 Dec 4.

  PMID: 24305648 BACKGROUND

MeSH Terms

Conditions

Athletic Injuries; Anterior Cruciate Ligament Injuries

Condition Hierarchy (Ancestors)

Wounds and Injuries; Knee Injuries; Leg Injuries

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Head of Orthopaedic Sports and Arthroscopy Division, Principal Investigator

Model Details: multi-site study 15 subjects on each group analysis

Study Record Dates

• First Submitted: July 16, 2020
• First Posted: September 2, 2020
• Study Start: February 1, 2015
• Primary Completion: February 28, 2017
• Study Completion: November 17, 2017
• Last Updated: September 2, 2020

Record last verified: 2020-08