Arthroscopically assisted anterior cruciate ligament reconstruction: comparison of bone-patellar tendon-bone versus hamstring tendon autograft.

BACKGROUND

The bone-patellar tendon-bone (BPTB) and the hamstring tendons are commonly used for arthroscopially-assisted anterior cruciate ligament (ACL) reconstruction.

PURPOSE

To compare the results of arthroscopically-assisted ACL reconstruction using bone-patellar tendon-bone and hamstring tendons grafts in terms of postoperative knee stability, knee functions and clinical rating scale, and patient satisfaction.

HYPOTHESIS

There was no difference in the outcomes of the two grafts.

STUDY DESIGN

Retrospective non-randomized clinical trial.

MATERIAL AND METHOD

Two groups of patients, 45 in the BPTB group and 30 in the hamstring group, were followed for at least one year.

RESULTS

The two groups had similar pre-operative data except the hamstring group which had a significantly shorter duration of injury before operation (9.5 versus 18 months, p < 0.05). There was no difference in median pre-operative Lysholm knee score (74 in the BPTB group versus 75 in the hamstring group, p > 0.05) and the post-operative one (95 in the BPTB group versus 99 in the hamstring group, p > 0.05). There was also no difference in the median pre-operative HSS knee score (58 in the BPTB group versus 61 in the hamstring group, p > 0.05). Although there was a statistically significant difference in the median post-operative HSS knee score between the two groups (95 in the BPTB group versus 96 in the hamstring group, p < 0.05), this was not clinically significant since both scores were rated as an excellent result. Both groups had a significantly improved knee stability and knee functions (Lysholm and HSS knee scores). The hamstring group, however, had significantly higher patient satisfaction (88% in the BPTB group versus 93% in the hamstring group, p < 0.05).

CONCLUSION

Both the BPTB and the hamstring tendon grafts resulted in significantly improved knee stability and functions with high patient satisfaction. The hamstring tendon group, however, had a significantly better post-operative patient satisfaction (Visual Analog Scale, VAS).