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KMID : 0828620080120010001
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Journal of Korean Arthroscopy Society
2008 Volume.12 No. 1 p.1 ~ p.6
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Anterior Cruciate Ligament Reconstruction: Comparison of Bone-Patellar tendon-Bone Grafts with Hamstring Tendon Grafts
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Choi Sung-Wook
Oh In-Suk
Kim Myung-Ku
Bae Joo-Han
Kim Ryuh-Sup
Park Hae-Bong
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Abstract
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Purpose: The purpose of this study is to compare the results of the arthroscopic reconstruction of ACL using autologous hamstring tendon and autologous bone-patellar tendon-bone.
Material and Methods : From January, 2000 to December, 2004, 120 patients underwent arthroscopic ACL reconstruction using autologous hamstring tendon (60 cases) and autologous bone-patellar tendon-bone (BPTB) (60 cases). The mean followed up period of hamstring tendon group was 42 months(range 24~69 months) and patellar tendon group was 52 months (range 24~84 months). At the time of the final follow up, sixty patients in each group were evaluated the results of physical examination, activity level, patients’satisfaction, functional status, and objective anteriror stability using KT-2000 arthrometer.
Results: At the time of the final follow up we compared the two groups who had ACL reconstruction using either autologous hamstring tendon or BPTB, and the final results of the Lachman test showed negative , or mildly positive in 85% (51 cases) of the hamstring tendon group and 90% (54 cases) of the BPTB group. Pivot shift test indicated positive in both groups, 8% (5 cases) and 5% (3 cases) respectively and showed no statistically significant difference. The evaluation of the anterior laxity using the KT-2000 arthrometer revealed no significant difference in the hamstring and BPTB groups: differences less than 3 mm compared to the healthy side were 85% (51 cases) and 90% (54 cases) (p＞0.05). The Lysholm score improved from a preoperative score of 51 to a postoperative score of 79.1 in the hamstring groups and from 52 to 82.2 in the BPTB groups. According to the IKDC rating system, 87% (52 cases) were normal or near normal in the hamstring group. In the BPTB group, 83% (50 cases) were normal or near normal. The Tegner score for the hamstring groups was 4.8 preoperatively and 7.1 at the final follow up, and the Tegner score for the BPTB groups was 4.5 preoperatively and 7.3 after the last follow-up. The anterior knee pain was found in 7% (4 cases) in the hamstring tendon group and 10% (6 cases) in the patellar tendon group.
Conclusion: Arthroscopic ACL reconstruction using both the autologous hamstring tendon and the patellar tendon during their mid term follow up period demonstrated excellent results. However, the final results during their last follow up showed no statistically significant difference between the two groups.
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KEYWORD
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autologous hamstring tendon, autologous bone-patellar tendon-bone, ACL reconstruction
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