A 7-year follow-up of patellar tendon and hamstring tendon grafts for arthroscopic anterior cruciate ligament reconstruction: differences and similarities.
BACKGROUND
For arthroscopic anterior cruciate ligament reconstruction, the most commonly used graft constructs are either the hamstring tendon or patellar tendon. Well-controlled, long-term studies are needed to determine the differences between the 2 materials.


OBJECTIVE
There is a difference between hamstring and patellar tendon grafts in the clinical results of anterior cruciate ligament reconstructions at 7 years.


METHODS
Cohort study; Level of evidence, 2.


METHODS
Two groups of 90 patients each, consecutively treated with hamstring or patellar tendon grafts, were followed and assessed at 1, 2, 5, and 7 years after surgery.


RESULTS
At the 7-year review, abnormal radiographic findings were seen in 45% (24/53) of the patellar tendon group and in 14% (7/51) of the hamstring tendon group (P = .002). Although there was no significant difference between the groups in extension deficit (P = .22), the percentage of patients with an extension deficit increased significantly in the patellar tendon group from 8% at 1 year to 25% at 7 years (P = .02). No significant change was seen in the hamstring tendon group over time (P = .20). There was no significant difference in laxity between the groups on Lachman (P = .44), pivot-shift (P = .39), or instrumented (P = .44) testing. Graft rupture occurred in 4 patients from the patellar tendon group and in 9 patients from the hamstring tendon group (P = .15). Both autografts gave excellent subjective results, as evidenced by the International Knee Documentation Committee evaluation and Lysholm knee scores at 7 years.


CONCLUSIONS
Both hamstring and patellar tendon grafts provided good subjective outcomes and objective stability at 7 years. No significant differences in the rate of graft rupture or contralateral anterior cruciate ligament rupture were identified. Patients with patellar tendon grafts had a greater prevalence of osteoarthritis at 7 years after surgery; therefore, the authors preferred hamstring tendons as the primary graft choice in anterior cruciate ligament reconstructions.
Roe
Justin
J
MB.BS, BSc(Med Australian Institute of Musculoskeletal Research, 286 Pacific Hwy, Sydney, NSW 2065, Australia. jroe@nsosmc.com.au
Pinczewski
Leo A
LA
Russell
Vivianne J
VJ
Salmon
Lucy J
LJ
Kawamata
Tomomaro
T
Chew
Melvin
M
D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D050376:Bone-Patellar Tendon-Bone Grafting; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D012421:Rupture; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome