Abstract
Aim: To determine the short to mid-term outcome differences between patellar tendon (PT) and hamstring (HS) autograft in anterior cruciate ligament (ACL) reconstructions.
Methods: Sixty-five patients undergoing primary ACL reconstruction were randomised to receive either a PT or a quadruple HS autograft. Post operatively patients undertook a standard “accelerated” rehabilitation protocol. Patients were reviewed at four and eight months and then after one, two and three years.
Results: Anterior knee pain was significantly more common in the PT group at eight months, and again at two years, but not at other times. Pain on kneeling was significantly greater in the PT group at four months and this difference persisted at three years. There was a significantly greater incidence of effusion in the PT group at eight months. Extension deficits were significantly greater in the PT group at eight months and this continued unchanged at three years. Active flexion deficits were significantly greater in the hamstring group at one and two years but not at three years.
KT-1000 side to side differences in anterior knee laxity were significantly greater in the HS group from four months through to three years. There were significantly greater peak quadriceps torque deficits in the PT group at four months and at eight months. Sports activity levels were significantly higher in the PT group at four months but this difference had resolved by eight months. Cincinnati scores were significantly higher in the HS group at one year but not thereafter. There was no difference in IKDC ratings between the two groups. Radiographic femoral tunnel widening was significantly more prevalent and greater in the HS but did not correlate with any clinical differences. Radiographic tunnel widening was present at four months and did not change significantly thereafter.
Conclusions: Overall, HS autografts were associated with less morbidity but increased anterior knee laxity and radiographic femoral tunnel widening compared with PT autografts. From a functional point of view, there was no significant difference between the two graft types at three years.
The abstracts were prepared by Professor A. J. Thurston. Correspondence should be addressed to him at the Department of Surgery, Wellington School of Medicine, PO Box 7343, Wellington South, New Zealand
