title: No significant difference in clinical outcome and knee stability between patellar tendon and semitendinosus tendon in anterior cruciate ligament reconstruction.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University Wuerzburg, Brettreichstr. 11, 97074, Würzburg, Germany. christian.konrads@gmail.com.
authors.forename: Christian
authors.initials: C
authors.lastname: Konrads
authors.affiliation: Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University Wuerzburg, Brettreichstr. 11, 97074, Würzburg, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Reppenhagen
authors.affiliation: Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University Wuerzburg, Brettreichstr. 11, 97074, Würzburg, Germany.
authors.forename: Piet
authors.initials: P
authors.lastname: Plumhoff
authors.affiliation: Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University Wuerzburg, Brettreichstr. 11, 97074, Würzburg, Germany.
authors.forename: Maik
authors.initials: M
authors.lastname: Hoberg
authors.affiliation: Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University Wuerzburg, Brettreichstr. 11, 97074, Würzburg, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Rudert
authors.affiliation: Department of Orthopaedic Surgery, König-Ludwig-Haus, Julius-Maximilians-University Wuerzburg, Brettreichstr. 11, 97074, Würzburg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Barthel
mesh_terms: D000293:Adolescent; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D017847:Patellar Ligament / Q000637:transplantation; D011446:Prospective Studies; D013710:Tendons / Q000637:transplantation*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anterior cruciate ligament (ACL); Arthritis; Instability; Knee; Patellar tendon; Semitendinosus tendon