Abstract
Introduction and Aims: Some authors have suggested that, in females, the results of ACL reconstruction using hamstring tendon (HS) grafts are inferior to those using patellar tendon (PT) grafts, while others have suggested that HS grafts may be preferable. This study compared the mid-term results of ACL reconstruction in females using both graft types.
Method: Sixty-six females who had undergone primary ACL reconstruction using either HS (n=43) or PT autograft (n=22) were evaluated at a mean 3.7 years follow-up (range 2.6–5.5). All procedures were performed by the same experienced knee surgeon using an arthroscopically assisted, single-incision technique, with Endobutton femoral fixation and interference screw tibial fixation. The same rapid rehabilitation protocol (immediate full extension and weight-bearing; no brace) was used for all patients. Assessment was performed by an independent orthopaedic surgeon and included IKDC 2000, SF-36 and Cincinatti Sports Activity scores and measurements of anterior knee pain (AKP), kneeling pain and anterior knee laxity (KT-1000).
Results: The overall results in both groups were good. One PT patient sustained a traumatic graft rupture. The HS patients had higher Cincinnati Sports Activity Scores (HS: 83 vs. PT: 72, p< 0.05), but there was no difference in IKDC subjective scores (HS: 89.6 vs. PT: 85.7). For the SF-36, the HS group scored significantly higher on Physical Functioning (HS: 95.4 vs. PT: 89.8, p< 0.01) and General Health subscales (HS: 87.5 vs. PT: 78.4, p< 0.05), but there were no differences for the other subscales. Although there was no significant difference in AKP between the two groups (HS: 1.3/10 vs. PT: 1.7), there was a significantly greater mean kneeling pain in the PT group (PT: 4.0/10 vs. HS: 1.3, p< 0.001). There was no difference between the groups in side to side difference in anterior knee laxity at 134N (HS: 1.7mm vs. PT: 1.8mm). Seventy percent HS and 71% PT patients had a difference of < 3mm, with all remaining patients having 3–5mm difference. There was no difference in terms of overall IKDC knee examination grade, but the HS group had a lesser (hyper)extension deficit (HS: 1.0° vs. PT: 1.8°, p< 0.05).
Conclusion: Both PT and HS ACL reconstructions appear to provide satisfactory results in females, but HS grafts are associated with fewer symptoms, a greater return to pre-injury level of activity and higher quality of life scores.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
None of the authors is receiving any financial benefit or support from any source.
