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Published on: April 30, 2014
A randomized comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction
Julian A Feller1, Kate E Webster
1La Trobe University Musculoskeletal Research Centre, Melbourne, Australia.
Background:
Patellar and hamstring tendon autografts are the most frequently used graft types for anterior cruciate ligament reconstruction, but few direct comparisons of outcomes have been published.
Hypothesis:
There is no difference in outcome between the two types of reconstruction.
Study Design:
Prospective randomized clinical trial.
Methods:
After isolated anterior cruciate ligament rupture, 65 patients were randomized to receive either a patellar tendon or a four-strand hamstring tendon graft reconstruction, and results were reviewed at 4, 8, 12, 24, and 36 months.
Results:
Pain on kneeling was more common and extension deficits were greater in the patellar tendon group. There were greater quadriceps peak torque deficits in the patellar tendon group at 4 and 8 months but not thereafter. In the hamstring tendon group, active flexion deficits were greater from 8 to 24 months, and KT-1000 arthrometer side-to-side differences in anterior knee laxity at 134 N were greater. Cincinnati knee scores, International Knee Documentation Committee ratings, and rates of return to preinjury activity levels were not significantly different between the two groups.
Conclusions:
Both grafts resulted in satisfactory functional outcomes but with increased morbidity in the patellar tendon group and increased knee laxity and radiographic femoral tunnel widening in the hamstring tendon group.
