A prospective comparison of bone-patellar tendon-bone and hamstring tendon grafts for anterior cruciate ligament reconstruction in male patients

Abstract

The aim of the study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using central-third, bone-patellar tendon-bone (BPTB Group) (n = 45) and four-strand semitendinosus/gracilis (ST/G Group) (n = 78) autografts in male patients. The type of study is non-randomised, prospective consecutive series. A consecutive series of 126 male patients, all with unilateral ACL ruptures, was included in the study. In both groups, interference screw fixation of the graft was used at both ends and 123/126 (97%) of the patients returned for the follow-up examination after a period of 25 (23-33) months. The pre-operative assessments in both groups were similar in terms of the Tegner activity level, the Lysholm knee scoring scale, KT-1000 measurements, one-leg-hop test and knee-walking test. A significant reduction in knee laxity as measured with the KT-1000 arthrometer, compared with the pre-operative assessments, was found in both groups (P < 0.001). No significant differences in the post-operative knee-laxity measurements were found between the groups. Both groups had a significantly improved functional outcome at follow-up in terms of the Lysholm knee scoring scale, Tegner activity level and one-leg-hop test. The BPTB Group had a significantly higher Tegner activity level at follow-up, compared with the ST/G Group (P = 0.02). Moreover, the patients in the BPTB Group were significantly more likely to have a Tegner activity level of 6 or above (P = 0.03). Otherwise, no significant differences were found between the two study groups at the 2-year follow-up. Two years after an ACL reconstruction, the two groups displayed no significant differences in terms of functional outcome and knee laxity. However, more patients in the BPTB Group returned to a higher Tegner activity level than that in the ST/G Group.

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

“…We agree with the literature [5,23] and believe that patellar tendon reconstructions with a standard approach, in which the incision is bigger than in hamstring procedures, should cause more sensory deficits. A bigger sample should confirm this.…”

“…Afterwards, they were asked to subjectively classify it as impossible, difficult, unpleasant or normal (following the described knee walking test [22,23]). They were also requested to crouch and classify subjectively as possible with pain, possible without pain, or impossible.…”

Self-reported activity level and knee function in amateur football players: the influence of age, gender, history of knee injury and level of competition

“…Increasingly, the Tegner Activity Scale is used as selfreported by patients, [12,16,19,31] and several recent publications did not describe the collection mode. [4,5,10,15,17,18,29] We could however not find any study supporting the use of the Tegner Activity Scale as a self-reported outcome. Football is represented at three different levels of this scale: 10 is equivalent to national level; 9 to competitive level; and 7 to recreational level.…”

Estudo comparativo da reconstrução do LCA com o posicionamento anatômico dos túneis entre o tendão patelar e os tendões flexores

“…In the cases with the patellar tendon, femoral fixation was achieved by means of the "press fit" technique: not only is this biological and safe (22,23) , but also it avoids screw deviation or breakage of the posterior cortical boner (17) . Although some authors have reported that patients have returned to a higher activity level with the patellar tendon (24) , Pinczewski (25) did not find any difference in results between the two types of graft, in series with ten years of follow-up. However, because of the lower morbidity from harvesting the flexor tendons, and because of the fewer radiographic abnormalities found in this group, these tendons were indicated as the first choice.…”

“…In the patellar tendon group, 26 (96.3%) were very satisfied (24) or satisfied (2), while one patient was dissatisfied. In the flexor tendon group, all the patients were either very satisfied (20) or satisfied (5) (p = 0.99) ( Table 7).…”