Pain level after ACL reconstruction: A comparative study between free quadriceps tendon and hamstring tendons autografts

Abstract

Objective: The objective of this study was to compare the pain levels and analgesic consumption aftersingle bundle ACL reconstruction with free quadriceps tendon autograft versus hamstring tendonautograft.Patients and methods: A total of 48 patients scheduled for anatomic single-bundle ACL reconstructionwere randomized into two groups: the free quadriceps tendon autograft group (24 patients) and thehamstring tendons autograft group (24 patients). A basic multimodal analgesic postoperative programwas used for all patients and rescue analgesia was provided with tramadol, at pain scores over 30 on theVisual Analog Scale. The time to theŞrst rescue analgesic, the number of doses of tramadol and painscores were recorded. The results within the same group were compared with the Wilcoxon signed test.Results: Supplementary analgesic drug administration proved signiŞcantly higher in the group of subjects with hamstring grafts, with a median (interquartile range) of 1 (1.3) dose, compared to the group ofsubjects treated with a quadriceps graft, median¼ 0.5 (0.1.25) (p ¼ 0.009). A signiŞcantly higher numberof subjects with a quadriceps graft did not require any supplementary analgesic drug (50%) as comparedwith subjects with hamstring graft (13%; Z-statistics¼ 3.01, p ¼ 0.002). The percentage of subjects whorequired a supplementary analgesic drug was 38% higher in the HT group compared with the FQT group.Conclusion: The use of the free quadriceps tendon autograft for ACL reconstruction leads to less pain andanalgesic consumption in the immediate postoperative period compared with the use of hamstringsautograft.Level of Evidence: Level I Therapeutic study© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).