Arthroscopic ACL Reconstruction: Hamstring Versus Quadriceps
Condition: Anterior Cruciate Ligament Injury; Anterior Cruciate Ligament Rupture
MeSH terms: Rupture; Anterior Cruciate Ligament Injuries
Study type: Interventional

Summary: 
      The use of hamstrings and quadriceps autografts as an alternative option for reconstruction
      of the anterior cruciate ligament has good clinical results: however, both techniques have
      not been compared among them, which is why this study is intended. The use of quadriceps
      tendon autograft in anterior cruciate ligament repair presents similar or better results
      compared to autograft of the hamstrings. The objective of the study is to compare the
      clinical effectiveness of anterior cruciate ligament reconstruction between the use of
      quadriceps tendon autograft versus hamstring autograft.
    

Detailed description: 
      Methods Institution Patients attending the Orthopedics and Traumatology consult of the
      Hospital Universitario "Dr. Jose Eleuterio Gonzalez" of the Universidad Autonoma de Nuevo
      Leon.

      Study design This is a double-blind , prospective, reproducible, comparative and longitudinal
      clinical trial with specific population.

      It is proposed to study 28 patients, being randomly divided into two groups. Inclusion
      criteria: patients of age between 18 years and 45 years, with anterior cruciate ligament
      (ACL) injury diagnosed clinically and by magnetic resonance image and with or without
      associated meniscal injury, without previous reconstruction surgery and with previous
      informed Consent.

      Exclusion criteria: multiligamentous injury and/or diagnosis of moderate or severe
      ostearthritis, chronic degenerative diseases (diabetes mellitus, hypertension) and
      contralateral ACL injury.

      Elimination criteria: own initiative to stop participating and those who didn't complete all
      follow-up appointments.

      Procedure Before surgery Detailed Informed Consent is performed to the patient before
      inclusion to the protocol Tegner Lysholm Knee Scoring Scale (evaluates the functionality of
      the knee and classifies them in grades with respect to its functional capacity) IKDC
      (evaluates knee ligament injuries, based on symptoms, sports activities and knee function)
      KOOS (evaluates knee sports injuries in young and middle-aged patients) Knee Society Score
      (pain, range of motion and injured knee stability) Cincinnati Knee Ligament Rating System
      (CKRS, assesses knee instability in ACL sports injuries) SF-12 (assesses patient's life
      quality) VAS (a subjective assesment of pain). Surgery The investigators will proceed to
      perform the anterior cruciate ligament reconstruction, both by the same surgeon, who will use
      the same technique in both groups, with the autograft in which the patient will have been
      randomly assigned.

      After surgery all patients will be discharged previous warning signs explanation and several
      appointments in 2 weeks, 1 month, 3, 6 and 12 months after the procedure, for later
      evaluation scales, mentioned previously Statistical analysis In the sample size calculation,
      14 patients per group are included using a mean equivalence formula, with 95% confidence and
      a power of 80%, estimating an equivalence of more less 2.5 on the Lysholm scale.
    

Intervention name(s): Hamstring; Quadriceps tendon
Intervention type(s): Procedure; Procedure
Intervention description(s): The intervention will consist of make an incision on the medial side of the proximal portion of the leg approximately 3 centimeters to dissect by planes until the tendons of the hamstrings are located, which will be removed surgically with specialized instruments and the wound will be closed, for later These tendons be used as an autograft for the reconstruction of the anterior cruciate ligament; orThe intervention consisted in making an incision in the anterior aspect of the distal portion of the thigh of approximately 3 centimeters to dissect by planes until locating the membranous portion of the quadriceps tendon, from which will be removed a portion of surgical way with specialized instruments and the Wound will be closed, for later this tendon to be used as an autograft for the reconstruction of the anterior cruciate ligament.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This is a double-blind clinical trial with specific population, prospective, reproducible, comparative and longitudinal.
It is proposed to study 28 patients, being randomly divided into two groups. We include patients of age between 18 years and 45 years, who have an anterior cruciate ligament injury diagnosed clinically and by image (magnetic resonance) and patients with or without associated meniscal injury, without previous reconstruction surgery and with previous informed Consent.
We exclude patients with multiligamentous injury and/or those who have diagnosis of moderate or severe ostearthritis, chronic degenerative diseases (diabetes mellitus, hypertension) and contralateral ACL injury.
We eliminate patients that for own initiative, wants to stop participating and those who didn't complete all follow-up appointments.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: ANTERIOR CRUCIATE LIGAMENT; INJURY; HAMSTRING; AUTOGRAFT; QUADRICEPS