No Difference in Knee Pain Between Bone-patellar Tendon-bone and Hamstring Autograft at 2-year Follow-up

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Previous studies suggest bone-patellar tendon-bone (BPTB) autografts may cause more anterior knee pain after anterior cruciate ligament reconstruction (ACLR).
• Hamstring (HT) autografts are an alternative, but direct comparisons of pain outcomes are crucial.

Purpose of the Study:

• To compare patient-reported outcome measures (PROMs) at 2-year follow-up for ACLR using BPTB versus HT autografts.
• To specifically assess differences in knee pain between the two graft types.

Main Methods:

• Retrospective cohort study of 411 patients undergoing primary ACLR (2009-2021).
• Collected 2-year PROMs including Knee Injury and Osteoarthritis Outcome Score (KOOS) and KOOS pain subscale.
• Utilized descriptive analyses, t tests, chi-squared tests, and ANOVA for statistical analysis (P ≤ .05).

Main Results:

• No significant difference in 2-year improvement or final KOOS pain subscale scores between BPTB and HT autografts (P > .05).
• Baseline overall KOOS was higher in the BPTB group, but 2-year change in KOOS was higher in the HT group (P < .001, P = .040).
• Overall KOOS at final follow-up did not differ significantly between BPTB and HT autografts (P = .136).

Conclusions:

• ACLR using BPTB autografts is not associated with worse knee pain compared to HT autografts at 2-year follow-up.
• These findings challenge previous assumptions about BPTB graft-associated pain.