A Prospective Randomized Comparison of Patellar Tendon versus Semitendinosus and Gracilis Tendon Autografts for Anterior Cruciate Ligament Reconstruction

Abstract

Seventy patients with patellar tendon or hamstring tendon autografts for single-incision anterior cruciate ligament reconstruction were evaluated at least 2 years after surgery. All reconstructions were performed by the same surgeon, and metal interference screws were used for fixation of all grafts. No significant differences were noted between groups for Lysholm score, reduction in activity, KT-1000 arthrometer findings, quadriceps muscle size, return to sports, or ability to jump and do hard cuts and pivots. Significantly more patients in the patellar tendon group had patellofemoral pain at 6 months after surgery than did the hamstring tendon patients (48% versus 20%), and at last follow-up the incidence of patellofemoral pain was 42% and 20%, respectively. Fourteen patients in the patellar tendon group and seven in the hamstring tendon group had loss of motion (approximately 5 degrees ). Four patients (two in each group) had treatment failures and their results were not included in the clinical examination data. At 2 years' follow-up, 97% of patients with patellar tendon grafts and 100% of patients with hamstring tendon grafts rated their results as good or excellent. We found that hamstring tendon grafts performed similarly to patellar tendon grafts, although fewer patients in the hamstring tendon group had patellofemoral pain and loss of motion.

Hamstring tendon autograft better than bone patellartendon bone autograft in ACL reconstruction A cumulative meta-analysis and clinically relevant sensitivity analysis applied to a previously published analysis

“…In the paper by Biau and co-workers, we identified 14 primary studies with data available on anterior knee pain from 1991 to 2005 (Marder et al 1991, Aglietti et al 1994, 1997, Callaway et al 1994, Aune et al 2001, Eriksson et al 2001a, b, Feller et al 2001, Ropke et al 2001, Beynnon et al 2002, Shaieb et al 2002, Ejerhed et al 2003, Feller and Webster 2003, Hantes et al 2004, Ibrahim et al 2005, Laxdal et al 2005, Biau et al 2006). Our cumulative meta-analysis showed that statistical significance that hamstring autograft reduces ante- …”

Comparative study between mono-bundle bone-patellar tendon-bone, double-bundle hamstring and mono-bundle bone-patellar tendon-bone combined with a modified Lemaire extra-articular procedure in anterior cruciate ligament reconstruction

“…Many conflicting publications exist with no real consensus. Improved long-term stability in the patellar tendon group and decreased sensory deficits in the hamstrings group are some of the tendencies shown in these studies [5][6][7][8][9][10][11].…”

Clinical Outcome at a Minimum of Five Years After Reconstruction of the Anterior Cruciate Ligament

“…Randomized, controlled trials have previously demonstrated the superiority of reconstruction compared with primary repair [1][2][3] . Additional randomized, controlled trials have shown no clinical differences in outcome between the use of patellar tendon autograft and the use of hamstring tendon graft [4][5][6][7][8][9][10][11] or between one and two-incision arthroscopic operative techniques 10,[12][13][14] . Thus, reconstructions of the anterior cruciate ligament have been performed to allow patients to resume activities, especially in sports requiring cutting and pivoting, and studies have shown overall good short-term function 15,16 .…”