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- Title
No significant difference in clinical outcome and knee stability between patellar tendon and semitendinosus tendon in anterior cruciate ligament reconstruction.
- Authors
Konrads, Christian; Reppenhagen, Stephan; Plumhoff, Piet; Hoberg, Maik; Rudert, Maximilian; Barthel, Thomas
- Abstract
<bold>Introduction: </bold>ACL reconstruction with either patellar tendon or semitendinosus tendon autografts are standard procedures. Between these two grafts might be differences in stability, morbidity, or long-term changes. This study investigates outcomes of ACL reconstruction with patellar tendon versus semitendinosus tendon autografts. We hypothesize no significant differences in clinical outcome and knee stability between both groups. <bold>Methods: </bold>In a randomized prospective trial, we operated 62 ACL-deficient patients, 45 males and 17 females with a mean age of 29.8 years (min. 18, max. 44). We reconstructed the ligament using either autologous patellar tendon (n = 31) or semitendinosus tendon (n = 31). After 10 years of follow-up, we investigated 47 patients of the study. For evaluation we used a standard clinical examination including one-leg jump test and KT-1000 instrumental translation measure, visual analog pain scale, IKDC subjective knee form, Lysholm score, Tegner activity scale, and standard X-rays of the knee. <bold>Results: </bold>The data did not show any significant differences between the two groups. Between 5 and 10 years after ACL reconstruction both groups started to develop degenerative arthritic changes, which were detectable in standard radiographs of the knee. At 10-year follow-up mean IKDC for the BPTB group was 1.8 (min. 1, max. 3) and for the ST group it was 2.2 (min 1, max. 4), p = 0.35. Regarding Tegner activity scale after 10 years, the BPTB group showed a mean score of 5.9 (min. 4, max. 9) versus 5.1 (min. 3, max. 7) in the ST group, p = 0.53. For the Lysholm score the BPTB group reached a mean of 92.0 (min. 63, max. 98) and the ST group 91.8 (min. 62, max. 98) points, p = 0.66. There is a tendency for higher donor site morbidity in the BPTB group than in the ST group, p = 0.07. <bold>Conclusions: </bold>Both, patellar tendon and semitendinosus tendon are safe autografts for ACL reconstruction. Regarding graft selection, individual patient-dependent factors should be considered. ACL reconstruction cannot fully restore pre-injury status of knee joint function in the majority of cases.
- Subjects
ANTERIOR cruciate ligament; PATELLAR tendon; AUTOGRAFTS; VISUAL analog scale; RADIOGRAPHS; TENDON transplantation; PATELLAR ligament transplantation; ANTERIOR cruciate ligament surgery; COMPARATIVE studies; KNEE injuries; LONGITUDINAL method; RESEARCH methodology; MEDICAL cooperation; RESEARCH; EVALUATION research; RANDOMIZED controlled trials; TREATMENT effectiveness
- Publication
Archives of Orthopaedic & Trauma Surgery, 2016, Vol 136, Issue 4, p521
- ISSN
0936-8051
- Publication type
journal article
- DOI
10.1007/s00402-015-2386-4