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Anterior cruciate ligament reconstruction (ACLR) is complicated by high failure rates in young active individuals. Failure of ACLR is associated with limited activity, reduced quality of life, increased socioeconomic costs and higher rates of osteoarthritis (OA). A lateral extra-articular tenodesis (LET) may provide greater stability to the ACLR; but, its effect on failure rate is unclear and surgery-induced lateral compartment OA is a concern. Recently, the quadriceps tendon (QT) has become a popular graft choice claiming stability equivocal to BPTB but without donor site morbidity. This study evaluates whether one graft is superior at reducing failure rates and minimizing donor site morbidity and by determining whether the addition of an LET contributes to reduced failure.
- To determine if graft type (QT, BPTB or HT) with or without a LET affects the rate of graft failure 2 years after ACLR.
- To determine if graft type (QT, BPTB or HT) with or without a LET affects patient-reported symptoms, function & QOL, performance-based measures of function and return-to-sports 2 years after ACLR.
- To determine if graft type (QT, BPTB or HT) with or without LET affects rates of intervention-related donor site morbidity, complications and adverse outcomes 2 years after ACLR.
- To determine if the addition of a particular graft type (QT, BPTB or HT) with or without a LET is a more cost-effective approach to ACLR.
Ages Eligible for Study: up to 25 Years (Child, Adult)
Sexes Eligible for Study: All
Accepts Healthy Volunteers: Yes
- An ACL-deficient knee,
- Skeletal maturity (i.e. closed epiphyseal growth plates on standard knee radiographs) but no older than 25 years of age,
- At least two of the following: participate in a competitive pivoting sport; have a pivot shift of grade 2 or greater; have generalized ligamentous laxity (Beighton score of ≥4) and/or genu recurvatum >10 degrees.
- Previous ACLR on either knee,
- Multiple ligament injury (two or more ligaments requiring surgery),
- Symptomatic articular cartilage defect requiring treatment other than debridement,
- >3 degrees of asymmetric varus,
- Inability to provide consent.
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
University of Minnesota, Minneapolis, Minnesota, United States, 55455
Mayo Clinic, Rochester, Minnesota, United States, 55905
Missouri Orthopaedic Institute, Columbia, Missouri, United States, 65201
Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States, 27101
University of Pittsburgh, Pittsburgh, Pennsylvania, United States, 15260
The Rector and Visitors of the University of Virginia, Charlottesville, Virginia, United States, 22903
Antwerp Orthopedic Center, Antwerp, Belgium, 2018
Banff Sport Medicine Clinic, Banff, Alberta, Canada, T1L 1B3
University of Calgary Sport Medicine Centre, Calgary, Alberta, Canada, T2N 1N4
Fraser Health Authority, New Westminster, British Columbia, Canada, V3L 5P5
Pan Am Clinic, Winnipeg, Manitoba, Canada, R3M 3E4
McMaster University, Hamilton, Ontario, Canada, L8N 3Z5
Queen's University, Kingston, Ontario, Canada, K7L 2V7
Fowler Kennedy Sport Medicine Clinic, London, Ontario, Canada, N6A 3K7
University of Ottawa, Ottawa, Ontario, Canada, K1N 6N5
St. Michael's Hospital, Toronto, Ontario, Canada, M5B 1W8
University Klinik Münster, Münster, Germany, 48149
Oslo University Hospital, Oslo, Norway, 0372
Sahlgrenska Institute, Gothenburg, Sweden, MXP4+W7
Stockholm South Hospital, Karolinska Institutet, Stockholm, Sweden, 922M+CC
University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom, CV2 2DX