I n a two-centre study, 164 patients with unilateral instability of the anterior cruciate ligament were prospectively randomised to arthroscopic reconstruction with either a patellar tendon graft using interference screw fixation or a quadruple semitendinosus graft using an endobutton fixation technique. The same postoperative rehabilitation protocol was used for all patients and follow-up at a median of 31 months (24 to 59) was carried out by independent observers. Four patients (2%) were lost to follow-up.No significant differences were found between the groups regarding the Stryker laxity test, one-leg hop test, Tegner activity level, Lysholm score, patellofemoral pain score, International Knee Documentation Committee (IKDC) score or visual analogue scale, reflecting patient satisfaction and knee function. Slightly decreased extension, compared with the non-operated side, was found in the patellar tendon group (p < 0.05). Patients with associated meniscal injuries had lower IKDC, visual analogue (p < 0.01) and Lysholm scores (p < 0.05) than those without such injuries. Patients in whom reconstruction had been carried out less than five months after the injury had better final IKDC scores than the more chronic cases (p < 0.05).We conclude that patellar tendon and quadruple semitendinous tendon grafts have similar outcomes in the medium term. Associated meniscal pathology significantly affects the final outcome and early reconstruction seems to be beneficial. The bone-patellar tendon-bone graft has been regarded as the procedure of choice in reconstruction of the anterior cruciate ligament (ACL) for more than two decades. [1][2][3][4] Alternatives include semitendinosus or combined semitendinosus/gracilis tendon grafts. Few of the numerous studies reflecting the functional outcome after these different procedures are prospective investigations and even fewer are both prospective and randomised.5-7 Combined semitendinosus and gracilis grafts have been used in previous randomised studies. To the best of our knowledge, no prospective, randomised study comparing bone-patellar tendon-bone grafts with quadruple semitendinosus tendon grafts has been published. The particular clinical issues relate to possible elongation of hamstring tendon grafts over time, their possible lower donor site morbidity, especially reflecting patellofemoral problems, and optimal fixation technique.Our aim was to compare arthroscopically-assisted reconstruction of the ACL using bone-patellar tendon-bone graft and interference screw fixation with quadruple semitendinosus tendon graft using endobutton fixation proximally and screws distally. Patients and MethodsBetween 1995 and 1997, in a two-centre study, 180 patients were prospectively randomised to reconstruction of the ACL with either an ipsilateral bone-patellar tendon-bone graft or a quadruple semitendinosus graft. Inclusion criteria were single-leg insufficiency of the ACL with the trauma occurring at least two months before reconstruction, age between 15 and 45 years, no previous reco...

No data have hitherto been published including all patients with CL injury, treated both surgically and nonsurgically. Such baseline epidemiologic data are crucial to be able to validate and judge the generalizability of results from procedure registers and clinical studies.

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The findings indicate that haptic feedback could be important in the early training phase of skill acquisition in image-guided surgical simulator training.

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In a two-centre study, 164 patients with unilateral instability of the anterior cruciate ligament were prospectively randomised to arthroscopic reconstruction with either a patellar tendon graft using interference screw fixation or a quadruple semitendinosus graft using an endobutton fixation technique. The same postoperative rehabilitation protocol was used for all patients and follow-up at a median of 31 months (24 to 59) was carried out by independent observers. Four patients (2%) were lost to follow-up. No significant differences were found between the groups regarding the Stryker laxity test, one-leg hop test, Tegner activity level, Lysholm score, patellofemoral pain score, International Knee Documentation Committee (IKDC) score or visual analogue scale, reflecting patient satisfaction and knee function. Slightly decreased extension, compared with the non-operated side, was found in the patellar tendon group (p < 0.05). Patients with associated meniscal injuries had lower IKDC, visual analogue (p < 0.01) and Lysholm scores (p < 0.05) than those without such injuries. Patients in whom reconstruction had been carried out less than five months after the injury had better final IKDC scores than the more chronic cases (p < 0.05). We conclude that patellar tendon and quadruple semitendinous tendon grafts have similar outcomes in the medium term. Associated meniscal pathology significantly affects the final outcome and early reconstruction seems to be beneficial.