Improved ACL reconstruction outcome using double-layer BPTB allograft compared to that using four-strand hamstring tendon allograft.
BACKGROUND
This study compared the clinical outcomes of anterior cruciate ligament reconstruction using double-layer bone-patellar tendon-bone (DBPTB) allografts and four-strand hamstring (4SHS) grafts.


METHODS
This prospective randomized controlled trial included 101 patients. Of these, 50 patients received DBPTB allografts, and 51 received 4SHS grafts. Evaluations included KT-1000 arthrometer measurements, Lachman tests, pivot-shift tests, the International Knee Documentation Committee (IKDC) classification and Lysholm scores at three year postoperative follow-up.


RESULTS
Two DBPTB patients (four percent) and nine 4SHS patients (17.6%) had graft failures, which was significantly different (P=0.028). The DBPTB group had significantly better Lachman test, IKDC knee score and Lysholm score results than the 4SHS group (P<0.05). However, these differences were below the threshold for clinical significance.


CONCLUSIONS
DBPTB allografts had fewer graft failures at three years than 4SHS grafts for anterior cruciate ligament reconstruction; and there were statistically significant differences but not clinically significant differences between DBPTB and 4SHS grafts in terms of the KT1000 test, IKDC and Lysholm scores.
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Hebei, China.
Yingzhen
Y
Niu
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Hebei, China.
Chao
C
Niu
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Hebei, China.
Xiaomeng
X
Wang
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Hebei, China.
Junhang
J
Liu
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Hebei, China.
Pengkai
P
Cao
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Hebei, China. Electronic address: niuyingzhen@yeah.net.
Fei
F
Wang
Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Hebei, China.
Jinghui
J
Niu
D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D050376:Bone-Patellar Tendon-Bone Grafting; D005260:Female; D005500:Follow-Up Studies; D000070632:Hamstring Tendons / Q000637:transplantation*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult
Anterior cruciate ligament; Anterior cruciate ligament reconstruction; Bone–patellar tendon–bone graft; Hamstring allograft