Introduction: Some authors have suggested that the results of ACL reconstruction in females using hamstring tendon (HS) autograft are inferior to those using patellar tendon (PT) autograft. The purpose of this study was to compare our results of ACL reconstruction in females using both graft types.

Material and methods: 80 females who had undergone primary ACL reconstruction using either HS (n=48) or PT (n=32) were evaluated at mean 3.7 year follow-up (2.4 – 5.7). The same surgeon carried out all the reconstructions, using Endobutton femoral fixation and interference screw tibial fixation, and the same rapid rehabilitation protocol was followed by all patients. Independent assessment included IKDC 2000, SF-36, and Cincinnati Sports Activity Score (CSAS) and measurements of anterior knee pain (AKP), kneeling pain and anterior knee laxity (KT-1000).

Results: One patient in the PT group sustained a traumatic graft rupture. For the remaining patients there were no significant differences between the two graft types in terms of objective IKDC 2000 or KT-1000. In terms of subjective IKDC the HS group scored significantly higher (PT: 85 pts., HS: 90pts, p< 0.05), as well as for the CSAS (PT:72.8 vs. HS: 82.1, p< 0.01) and for the SF-36 on the Physical Functioning (PT:90 vs. HS:95, p< 0.01) and General Health subscales (PT:79 vs. HS 86, p< 0.05). Although there was no significant difference in AKP between the two groups, there was a significantly greater mean kneeling pain in the PT group (PT:4.1 vs. HS: 2.5, p=0.001).

Conclusions: Both PT and HS primary ACL reconstructions appear to provide comparable good objective results in females, but ACL reconstruction with HS showed significantly better subjective results. This finding seems to be related to less donor site problems compared with PT. Our results indicate that a quadruple hamstring autograft is an adequate alternative to a patellar tendon autograft for ACL reconstruction in female patients.