Quadriceps tendon autograft for primary ACL reconstruction: a Bayesian network meta-analysis

Background: The purpose of the current study was to clarify the role of the quadriceps tendon (QT) autograft for primary ACL reconstruction. Thus, a Bayesian network meta-analysis comparing patients undergoing a primary ACL reconstruction with QT versus patellar tendon (PT) and hamstring tendon (HT) autografts was conducted. Material and methods: This Bayesian network meta-analysis was conducted according to the PRISMA extension statement for reporting systematic reviews incorporating network meta-analyses of health care interventions. In January 2020, the main databases were accessed. Articles comparing the outcomes of the QT autograft versus HT autograft and/or PT autograft for primary ACL reconstruction were included in the present study. The statistical analysis was performed with STATA Software/MP, through a Bayesian hierarchical random-effect model analysis. Results: Data from a total of 2603 knees were analysed. The overall mean follow-up was 35.0 months. Among the different grafts were evidenced comparable values of IKDC, Tegner and Lysholm score. The QT autograft detected comparable rate of Lachman test ' 3 mm, Pivot shift test ' 3 m and instrumental laxity ' 3 mm. The QT autograft showed a lower rate of autograft failure above all. The QT autograft detected the reduced rate of AKP than the PT. Conclusion: Quadriceps tendon autograft may represent a feasible option for primary ACL reconstruction. These results must be interpret within the limitations of the present network meta-anlaysis.