Postoperative Knee Pain And Function After Quadriceps Tendon Acl Reconstruction: Impact Of Lateral Extra-articular Tenodesis

BACKGROUND: The use of all-soft tissue quadriceps tendon autografts (ASTQT) is increasing for anterior cruciate ligament reconstruction (ACLR). Further, interest in adding lateral extra-articular tenodesis (LET) augmentation to ACLR to improve knee stability is also increasing. However, the effects of adding LET to ASTQT ACLR on patient-reported outcomes (PROs) is limited. PURPOSE: To evaluate postoperative changes in PROs following ASTQT ACLR with and without LET. METHODS: Data from 75 patients with (n = 21) and without LET (n = 54) were collected (17.26+/- 3.96 years; 73% female). Patient-reported outcomes (PROs) were assessed at five-time points (pre-operatively to 12 months; see Figure 1). Frequently measured PROs were evaluated (e.g., knee function, pain). Generalized Estimated Equations (GEEs) were used to test the effects of time, group (ASTQT, ASTQT + LET), and time x group interaction for each PRO. RESULTS: No significant group or time x group interactions existed for any PRO (p’s > .05). Significant improvements in knee pain and function in sport were observed at 9 and 12 months (p < .05), with partial eta-squared values of 0.74 and 0.88. Pain interference and severity showed consistent reductions at all time points (3, 6, 9, and 12 months), with significant overall time effects (p < .05) and partial eta-squared values of 0.96 and 0.92. Significant improvements across all time points were also seen for kinesiophobia (η2 = 0.89), physical activity (η2 = 0.90), and general knee function (η2 = 0.97), all p < .05. CONCLUSIONS: Consistent longitudinal improvements in PROs were observed following ASTQT ACLR independent of LET augmentation. However, LET augmentation did not influence the trajectory of any PRO during the first 12 months post ACLR, indicating patients’ self-reported recovery with LET was comparable to ASTQT alone. Future research should consider monitoring changes in PROs relative to other long-term outcomes including secondary ACL injury.