Patient Interest in Quadriceps Autograft ACL Reconstruction is Increasing Over Other Autograft Options: A 12-year Google Trends Analysis

Purpose The purpose of this study was to use Google trends to explore differences in public interest among types of anterior cruciate ligament (ACL) autografts, specifically quadriceps tendon, patellar tendon, and hamstring tendon autografts between 2008 and 2019. Methods Data were obtained by querying Google Trends for key terms and phrases for online search data ranging from January 2008 to December 2019. Relative search volumes were created based on searches related to anterior cruciate ligament reconstruction with comparative analysis generated for search terms related to quadriceps ACL, patellar tendon ACL, and hamstring ACL autografts. Statistical analysis included linear regression analysis, comparison of quarterly search volume trends over time, and comparison of cumulative annual search volumes for 2008 versus 2019. Results Linear models for respective search terms terms were statistically significant for the quadriceps (p<0.001) and patellar (p 0.007) tendon autograft groups, but not the hamstring group (p 0.129). The quadriceps autograft group demonstrated a 12-year search volume trend change of 0.56, which was significantly greater than the hamstring (0.07; p <0.001) and patellar tendon (0.168; p<0.001) groups. There was no significant difference in the trend change between hamstring and patellar tendon groups (p 0.20). Percent change in cumulative relative annual search volumes between 2008 and 2019 was 112% for the quadriceps tendon group, 12.9% for the hamstring group, and 18.6% for the patellar tendon group. Conclusion This study indicates a consistently increasing public interest in quadriceps tendon autograft for ACL reconstruction. The quadriceps autograft group demonstrated a significantly greater 12-year online search volume trend, greater linear correlation, and larger percent change between 2008 and 2019 when compared to patellar tendon or hamstring autograft groups.