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

Previous literature has suggested that bone-patellar tendon-bone (BPTB) autograft can be associated with more postoperative anterior knee pain compared to other graft types during anterior cruciate ligament reconstruction (ACLR). This study aimed to compare the differences between patients undergoing ACLR with either BPTB or hamstring (HT) autografts, focusing on 2-year follow-up patient-reported outcome measures (PROMs).

A retrospective cohort study of a prospectively collected PROMs database was conducted for 411 patients who underwent primary ACLR between 2009 and 2021. Outcomes collected included 2-year Knee Injury and Osteoarthritis Outcome Score (KOOS), the KOOS pain subscale, and a Single Assessment Numeric Evaluation. Statistical analysis consisted of descriptive analyses (eg, counts, means, ranges), independent-sample t tests, chi-squared tests, as well as analysis of variance. The level of statistical significance was set at P ≤ .05.

The 2-year improvement and final KOOS pain subscale from the preoperative baseline was not found to be significantly different between the groups (BPTB: 91.6 vs HT: 90.6; BPTB: 12.5 vs HT: 15.2, P = .065, P = .633, respectively). The baseline overall KOOS was higher in BPTB autograft cohort and the 2-year change in KOOS was higher in the HT autograft cohort when compared to other autograft cohort (68.2 vs 63.6, P < .001; 16.4 vs 19.7, P = .040, respectively). Overall KOOS at final follow-up did not differ between autografts (84.6 vs 83.0, P = .136, respectively).

ACLR with BPTB autograft was not found to be associated with worse knee pain scores compared to HT autograft at 2-year follow-up.