A five-year comparison of patellar tendon versus four-strand hamstring tendon autograft for arthroscopic reconstruction of the anterior cruciate ligament

• Published in: The American journal of sports medicine Vol. 30; no. 4; p. 523
• Main Authors: Pinczewski, Leo A, Deehan, David J, Salmon, Lucy J, Russell, Vivianne J, Clingeleffer, Amanda
• Format: Journal Article
• Language: English
• Published: United States 01.07.2002
• Subjects: Adolescent; Adult; Anterior Cruciate Ligament; Arthroscopy; Female; Humans; Knee Injuries - physiopathology; Knee Injuries - rehabilitation; Knee Injuries - surgery; Male; Prospective Studies; Range of Motion, Articular; Reconstructive Surgical Procedures; Rupture; Tendons - transplantation; Transplantation, Autologous; Treatment Outcome
• ISSN: 0363-5465
• DOI: 10.1177/03635465020300041201

The choice of graft material for anterior cruciate ligament reconstruction is believed to play a major role in outcome, but most comparisons of graft choice have not been well controlled. The choice of graft material (patellar tendon or hamstring tendon) does affect clinical outcome after anterior cruciate ligament reconstruction. Prospective, nonrandomized clinical trial. Two groups of 90 patients each were followed for a minimum of 5 years. International Knee Documentation Committee assessment revealed that more than 85% of each group had an overall score of A or B at all follow-up intervals. The median Lysholm knee score was greater than 90 for both groups at 2 and 5 years. Instrumented testing revealed no significant difference between the two groups beyond 3 years. Thirty-one percent of the patellar tendon group (25) had a fixed flexion deformity and 19% of the hamstring tendon group (14) had fixed flexion deformity at 5 years. Radiologic assessment revealed early osteoarthritic changes in 4% of the hamstring tendon group (2) and in 18% of the patellar tendon group (11) at 5 years. Arthroscopic reconstruction with either graft results in a similar surgical outcome, reliably restoring knee stability over a 5-year period; however, patients with patellar tendon grafts are at greater risk of developing early signs of osteoarthritis.