“Morbilidad de sitio donador y resultados funcionales durante la rehabilitación de pacientes operados de reconstrucción de ligamento cruzado anterior con injerto hueso-tendón-hueso versus tendón de cuádriceps. Un ensayo clínico controlado.

Abstract

Introduction: Anterior cruciate ligament (ACL) reconstruction is one of the most frequently performed procedures in sports orthopedics. Although the bone–patellar tendon–bone (BPTB) graft remains a reference option, the quadriceps tendon graft has emerged as an alternative potentially associated with lower donor-site morbidity and comparable functional outcomes.

Objective: To compare donor-site morbidity and functional outcomes during rehabilitation in patients undergoing primary ACL reconstruction using either a BPTB graft or a quadriceps tendon graft.

Materials and Methods: A prospective, longitudinal, randomized, double-blind controlled clinical trial was conducted. Fifty-four patients undergoing primary ACL reconstruction were included and allocated into two groups: BPTB (n=27) and quadriceps tendon (n=27). Outcomes assessed at 3, 6, and 12 months postoperatively included pain (VAS), quality of life (KOOS), function (IKDC and Kujala scores), muscle strength (MRC scale), range of motion, thigh circumference, kneeling ability, and sensory disturbances.

Results: The quadriceps tendon group demonstrated significantly better scores in the KOOS quality-of-life domain at 6 months of follow-up (58.2 vs. 42.2 points; p=0.011). The prevalence of pain at 3 months was higher in the BPTB group compared with the quadriceps tendon group (96% vs. 65.4%; p=0.011). No significant differences were observed between groups regarding overall pain, muscle strength, range of motion, thigh circumference, or functional outcome scores at 12 months.

Conclusions: The quadriceps tendon graft was associated with lower donor-site morbidity and improved quality of life during rehabilitation, particularly at six months after surgery. Both grafts demonstrated comparable functional outcomes at one year of follow-up, supporting the quadriceps tendon as an effective alternative for primary ACL reconstruction.