The patient is skeletally mature; i.e., epiphyseal growth plates are closed: if no, we need to upload the AP and Lateral View Radiographs
Two or more of the following criteria are true for the patient:
The patient competes in a competitive pivoting sport
The patient has generalized ligamentous laxity (i.e., Beighton score of 4 or greater)
The patient has a pivot shift of 2 or greater
The patient has a genu recruvatum of more than 10 degrees
Exclusion Criteria
The patient is younger than 14 or older than 25 years of age
The patient has undergone previous ACL reconstruction of either knee
The patient requires repair or reconstruction of the PCL, MCL, or LCL
The patient has a symptomatic articular cartilage defect that requires treatment other than debridement
The patient has a past/present history of inflammatory arthritis, metabolic bone, collagen, degenerative joint, or neoplastic disease
The patient has a femoral, tibial, or patellar fracture (other than Segond fractures)
The patient has an asymmetric varus or valgus greater than 3 degrees
The patient has a debilitating (per discretion of the treating surgeon) anterior knee pain that would preclude the use of QT or BPTB tissue as a graft
The patient has significant (per discretion of the treating surgeon) patellar or quad tendon tendonitis that would preclude the use of that tissue as a graft
The patient has a cognitive impairment or psychiatric illness that precludes informed consent OR renders the patient unable to complete questionnaires
The patient has no fixed address or means of contact
The patient has a major medical illness where life expectancy is less than 2 years
The patient is pregnant
The patient is not available for follow-up at specified time periods of before surgery, 3 months, 6 months, 12 months, 24 months post surgery
Other (per discretion of the surgeon)
Study Summary
Screening: Baseline questionnaires, clinical exam (pivot shift and ROM)
Surgery: Randomization will be done in the OR after completing inta-operative inclusion/exclusion review. Randomization groups:
ACLR with QT
ACLR with QT and LET
ACLR with BPTB
ACLR with BPTB and LET
Clinical Follow-Ups:
6 weeks, 3months, 6 months, 12 months, 24 months
All visits will include ROM (by blinded assessor), pivot shift, PROs
Standing flexion x-ray at 24 month visit
STEP/LEAP Follow-Ups:
6 month, 12 month and 24 months
Muscle strength by biodex or dynamometer- 6, 12, and 24mo
Functional Hop Series- 6, 12, and 24mo
Drop Vertical Jump- 6 and 12 month
Payment:
$290 total
Baseline: $50
6-week PROs: $20
12-week PROs: $20
6-month: $50 ($25 for visit and PROs, $25 for LEAP test)
12 month: $50 ($25 for visit and PROs, $25 for LEAP test)
24 month: $50 ($25 for visit and PROs, $25 for LEAP test)
Incentive payment: if a subject completes all components of the 6, 12, and 24 month visits, they get an extra $50
