Comparison of Patellar Tendon and Hamstring Tendon Anterior Cruciate Ligament Reconstruction

Webster, Kate E.; Feller, Julian A.; Hartnett, Nigel; Leigh, Warren; Richmond, Anneka K.

doi:10.1177/0363546515611886

Cited by 155 publications

(150 citation statements)

References 33 publications

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“…64 However, a higher incidence of meniscus surgery was present in the patellar tendon group, and not all studies were randomised. 64 This finding has not been confirmed from other long-term reports, 28,65,67 and it may be associated with the increased laxity found in the PT group at seven years versus two-year follow-up. 10 However, further research with long-term follow-up studies is necessary in order to clarify whether this association exists.…”

Section: Principles Of Acl Reconstructioncontrasting

confidence: 60%

Anterior cruciate ligament reconstruction: principles of treatment

2016

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Anterior cruciate ligament (ACL) reconstruction is one of the most common procedures in sports medicine. Several areas of controversy exist in ACL tear management which have engaged surgeons and researchers in debates towards identifying an ideal approach for these patients.This instructional review discusses the principles of ACL reconstruction in an attempt to provide guidelines and initiate a critical thinking approach on the most common areas of controversy regarding ACL reconstruction.Using high-level evidence from the literature, as presented in randomised controlled trials, systematic reviews, and meta-analyses, operative versus conservative treatment, timing of surgery, and rehabilitation are discussed. Also, the advantages and disadvantages of the most common types of autografts, such as patellar tendon and hamstrings as well as allografts are presented.Key considerations for the anatomical, histological, biomechanical and clinical data (‘IDEAL’) graft positioning are reviewed.Cite this article: Paschos NK, Howell SM. Anterior cruciate ligament reconstruction: principles of treatment. EFORT Open Rev 2016;398-408. DOI: 10.1302/2058-5241.1.160032.

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Section: Principles Of Acl Reconstructioncontrasting

confidence: 60%

Anterior cruciate ligament reconstruction: principles of treatment

2016

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“…Patients treated with patellar tendon grafts had modestly increased odds of returning to their preinjury level sport compared with those with hamstring tendon grafts 28 . On the other hand, people who received hamstring tendon grafts had more probability of returning 28 . Moreover, the literature shows an increased risk of ACL graft rupture for hamstring grafts 7 .…”

Section: Discussionmentioning

confidence: 90%

Returning to sport after anterior cruciate ligament reconstruction in amateur sports men: a retrospective study

Notarnicola

Maccagnano

Barletta

et al. 2016

MLTJ

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SummaryBackground: According to the literature, 95% of professional athletes return to their sport after anterior cruciate ligament (ACL) reconstruction surgery. The main objective of this study was to verify the return to sport after ACL reconstruction in a homogenous group of amateur sportsmen and sportswomen in a series of Italian patients. Materials and methods: We designed a retrospective study in which we analyzed the amateur sports patients operated for ACL reconstruction. We verified whether they had returned to sporting activities by comparing the pre-and post-operative Tegner activity scores. We then analyzed the average time to restart the sporting activity and the Lysholm and International Knee Documenting Committee (IKDC) scores. Results: We analyzed 80 subjects: 47.5% restarted a sports activity, on average after eight months, with a significant reduction of their competitive level or physical commitment, as expressed by the Tegner activity score (pre-operative: 6.9; post-operative: 3.9; p<0.01). The functional knee recovery was good, as expressed by the average score of the Lyshom Knee Scoring Scale (93.5) and the IKDC (74.7). Conclusions: In the literature, a return to sport for international case studies and amateur sports is higher than our data. In our population we found the lack of information provided by the medical staff at discharge and follow-up. The assessment at a short-term follow up allowed us to verify that at the end of the post-surgical rehabilitation program the patients were uninformed about the timing and the ability to resume a sporting activity. An efficacious relationship between orthopedic doctor, physiotherapist and a doctor in motorial science may ensure proper treatment the patient after ACL reconstruction. It is important to guarantee the restarting of the sports activity to have a better quality of life in amateur sports. Level of evidence: V.KEY WORDS: return to sport, soccer, knee, surgery, anterior cruciate ligament.

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“…3,22 The tibial fixation of HS grafts included interference screws in 6 studies 1,5,7,8,10,19 and washer/screw, staples, and “sutures through an adjacent bone bridge” in all others (6/12). 3,6,17,21,22,24 …”

Section: Resultsmentioning

confidence: 99%

Long-Term Outcomes in Anterior Cruciate Ligament Reconstruction: A Systematic Review of Patellar Tendon Versus Hamstring Autografts

Poehling-Monaghan

Salem

Ross

et al. 2017

Orthopaedic Journal of Sports Medicine

113

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Background:Much controversy still exists surrounding graft choice in anterior cruciate ligament (ACL) reconstruction. Over the past decade, an increase in comparative studies with longer follow-up has enhanced our understanding of current graft options and outcomes.Purpose:To describe the long-term comparative outcomes of ACL reconstruction with autograft bone–patellar tendon–bone (BPTB) versus autograft hamstring (HS) ACL reconstruction with regard to clinical and radiographic outcomes.Study Design:Systematic review; Level of evidence, 2.Methods:A search of the PubMed, MEDLINE, Cochrane, and Scopus databases was performed to identify studies in the English language with outcome data comparing ACL reconstruction utilizing autograft BPTB and autograft HS; only studies with a minimum 5-year follow-up were included. Outcome data included failure and complications, manual and instrumented laxity, patient-reported outcomes, and radiographic risk of osteoarthritis.Results:Twelve studies with a total of 953 patients met the inclusion criteria. Of these studies, 8 were level 1 evidence and 2 were level 2. Mean follow-up was 8.96 years (range, 5-15.3 years). No differences in graft failure or manual or instrumented laxity were seen in any studies. Lower clinical outcomes scores and greater motion loss were seen in BPTB patients in 1 and 2 studies, respectively. Two of 4 studies reporting on anterior knee pain, and 3 of 7 that recorded kneeling pain found it more frequently among BPTB patients. One study found significantly increased reoperation rates in HS patients, while another found a similar result in BPTB, and 1 study reported a significant increase in contralateral ACL tears in BPTB patients. Three of 5 studies reporting on radiographic evidence of osteoarthritis noted significantly increased rates in BPTB patients.Conclusion:This systematic review comparing long-term outcomes after ACL reconstruction with either autograft BPTB or autograft HS suggests no significant differences in manual/instrumented laxity and graft failures between graft types. An increase in long-term anterior knee pain, kneeling pain, and higher rates of osteoarthritis were noted with BPTB graft use.

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Comparison of Patellar Tendon and Hamstring Tendon Anterior Cruciate Ligament Reconstruction

Cited by 155 publications

References 33 publications

Anterior cruciate ligament reconstruction: principles of treatment

Anterior cruciate ligament reconstruction: principles of treatment

Returning to sport after anterior cruciate ligament reconstruction in amateur sports men: a retrospective study

Long-Term Outcomes in Anterior Cruciate Ligament Reconstruction: A Systematic Review of Patellar Tendon Versus Hamstring Autografts

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