TY - JOUR
T1 - Knee Extensor Mechanism Complications After Autograft Harvest in ACL Reconstruction
T2 - A Systematic Review and Meta-analysis
AU - Trasolini, Nicholas A.
AU - Lan, Rae
AU - Bolia, Ioanna K.
AU - Hill, William
AU - Thompson, Ashley A.
AU - Mayfield, Cory K.
AU - Knapik, Derrick M.
AU - Cole, Brian J.
AU - Weber, Alexander E.
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2023/7
Y1 - 2023/7
N2 - Background: Existing systematic reviews have sought to characterize the relative donor-site morbidity of bone–patellar tendon–bone (BTB) and quadriceps tendon (QT) grafts after anterior cruciate ligament reconstruction (ACLR). However, no studies have reported the pooled proportions of patellar fractures and donor tendon ruptures across the body of literature. Purpose: To estimate the proportion of patellar fractures, patellar tendon ruptures, and QT ruptures associated with BTB or QT autograft harvest during ACLR using published data. Study Design: Systematic review; Level of evidence, 4. Methods: A meta-analysis was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using 3 online databases (PubMed, Scopus, and Web of Science). A total of 800 manuscripts were included in the initial research of peer-reviewed articles in English that reported extensor mechanism complications associated with graft harvest in patients after ACLR. Pooled proportions of patellar fractures, patellar tendon ruptures, and QT ruptures were calculated for each graft type (BTB, QT) using a random-effects model for meta-analysis. Results: A total of 28 studies were analyzed. The pooled proportion of patellar fractures was 0.57% (95% CI, 0.34%-0.91%) for the BTB harvest and 2.03% (95% CI, 0.78%-3.89%) for the QT harvest. The proportion of patellar tendon ruptures was 0.22% (95% CI, 0.14%-0.33%) after the BTB harvest, and the proportion of QT ruptures was 0.52% (95% CI, 0.06%-1.91%) after the QT harvest. The majority of included studies (16/28 [57.1%]) had an evidence level of 4. Conclusion: Based on the current literature, the proportion of extensor mechanism complications after ACLR using either a BTB or a QT autograft is low, indicating that the extensor mechanism harvest remains a safe option. A higher proportion of patellar fractures was noted for QT grafts and a higher proportion of donor tendon ruptures was noted for QT grafts compared with BTB grafts.
AB - Background: Existing systematic reviews have sought to characterize the relative donor-site morbidity of bone–patellar tendon–bone (BTB) and quadriceps tendon (QT) grafts after anterior cruciate ligament reconstruction (ACLR). However, no studies have reported the pooled proportions of patellar fractures and donor tendon ruptures across the body of literature. Purpose: To estimate the proportion of patellar fractures, patellar tendon ruptures, and QT ruptures associated with BTB or QT autograft harvest during ACLR using published data. Study Design: Systematic review; Level of evidence, 4. Methods: A meta-analysis was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using 3 online databases (PubMed, Scopus, and Web of Science). A total of 800 manuscripts were included in the initial research of peer-reviewed articles in English that reported extensor mechanism complications associated with graft harvest in patients after ACLR. Pooled proportions of patellar fractures, patellar tendon ruptures, and QT ruptures were calculated for each graft type (BTB, QT) using a random-effects model for meta-analysis. Results: A total of 28 studies were analyzed. The pooled proportion of patellar fractures was 0.57% (95% CI, 0.34%-0.91%) for the BTB harvest and 2.03% (95% CI, 0.78%-3.89%) for the QT harvest. The proportion of patellar tendon ruptures was 0.22% (95% CI, 0.14%-0.33%) after the BTB harvest, and the proportion of QT ruptures was 0.52% (95% CI, 0.06%-1.91%) after the QT harvest. The majority of included studies (16/28 [57.1%]) had an evidence level of 4. Conclusion: Based on the current literature, the proportion of extensor mechanism complications after ACLR using either a BTB or a QT autograft is low, indicating that the extensor mechanism harvest remains a safe option. A higher proportion of patellar fractures was noted for QT grafts and a higher proportion of donor tendon ruptures was noted for QT grafts compared with BTB grafts.
KW - anterior cruciate ligament
KW - autograft
KW - patellar fracture
KW - patellar tendon
KW - quadriceps tendon
UR - http://www.scopus.com/inward/record.url?scp=85164976101&partnerID=8YFLogxK
U2 - 10.1177/23259671231177665
DO - 10.1177/23259671231177665
M3 - Review article
C2 - 37465207
AN - SCOPUS:85164976101
SN - 2325-9671
VL - 11
JO - Orthopaedic Journal of Sports Medicine
JF - Orthopaedic Journal of Sports Medicine
IS - 7
ER -