Comparison of Outcomes of Anterior Cruciate Ligament Reconstructions Using Patellar Tendon or Hamstring Tendon Autografts with Femoral Cross-pin Fixation
Öz
Aim: In this study, we aimed to compare outcomes of anterior cruciate ligament (ACL) reconstructions using bone–patellar tendon–bone graft (BPTG) or hamstring tendon graft (HTG) with cross-pin fixation at the femoral side.
Materials and Methods: The retrospective observational study included records of 100 patients who underwent ACL reconstruction with femoral cross-pin fixation between May 2008 and August 2012. The patients were divided into two groups according to the graft type used: the BPTG group and the HTG group. The preoperative and postoperative 6th-month Tegner Lysholm Knee Scoring Scale (TLKS) scores, International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC-SKF) scores, and Lachman test results were compared. The effects of meniscus lesion presence on the outcomes were also investigated.
Results: Of the 100 patients, 93 were male and 7 female. The HTG and BPTG groups consisted of 62 and 38 patients, respectively. The mean age was 24.1±4.9 (18–38) years for the HTG group and 32.1±6.8 (21–54) years for the BPTG group. The mean pre- and postoperative TLKS scores were respectively 50.5 and 94.3 in the BPTG group, and 49.9 and 95.2 in the HTG group. The mean pre- and postoperative IKDC-SKF scores were 51.3 and 95.6 in the BPTG group, and 51.8 and 95.6 in the HTG group. The postoperative score improvement was statistically significant in all patients (p<0.05), but there was no significant difference between the two groups. The postoperative improvement in knee stability was statistically significant in all patients (p<0.05). The postoperative score improvement was less in patients with meniscal injury (p<0.05).
Discussion and Conclusion: We found no significant difference between the two groups in terms of functional knee scores. However, the presence of meniscus lesions negatively affects the postoperative outcomes.
Anahtar Kelimeler
Anterior Cruciate Ligament Reconstruction, Orthopedic Fixation Devices, bone–patellar tendon–bone autograft, hamstring autograft
Kaynakça
- 1. Siegel L, Vandenakker-Albanese C, Siegel D. Anterior cruciate ligament injuries: anatomy, physiology, biomechanics, and management. Clin J Sport Med. 2012;22(4):349–55.
- 2. Mahapatra P, Horriat S, Anand BS. Anterior cruciate ligament repair—past, present and future. J Exp Orthop. 2018;5(1):20.
- 3. Duchman KR, Lynch TS, Spindler KP. Graft selection in anterior cruciate ligament surgery: who gets what and why? Clin Sports Med. 2017;36(1):25–33.
- 4. Holm I, Øiestad BE, Risberg MA, Gunderson R, Aune AK. No differences in prevalence of osteoarthritis or function after open versus endoscopic technique for anterior cruciate ligament reconstruction: 12-year follow-up report of a randomized controlled trial. Am J Sports Med. 2012;40(11):2492–8.
- 5. Vyas D, Rabuck SJ, Harner CD. Allograft anterior cruciate ligament reconstruction: indications, techniques, and outcomes. J Orthop Sports Phys Ther. 2012;42(3):196–207.
- 6. Pinczewski L, Roe J, Salmon L. Why autologous hamstring tendon reconstruction should now be considered the gold standard for anterior cruciate ligament reconstruction in athletes. Br J Sports Med. 2009;43(5):325–7.
- 7. Phillips BB, Mihalko MJ. Arthroscopy of the lower extremity. In: Campbell’s Operative Orthopaedics, 13. ed. Philedelphia: Elsevier; 2013.
- 8. Samuelsen BT, Webster KE, Johnson NR, Hewett TE, Krych AJ. Hamstring autograft versus patellar tendon autograft for ACL reconstruction: is there a difference in graft failure rate? A meta-analysis of 47,613 patients. Clin Orthop Relat Res. 2017;475(10):2459–68.
- 9. Gifstad T, Foss OA, Engebretsen L, Lind M, Forssblad M, Albrektsen G, et al. Lower risk of revision with patellar tendon autografts compared with hamstring autografts. Am J Sports Med. 2014;42(10):2319–28.
- 10. Coffey R, Bordoni B. Lachman test. In: Rheumatology and Immunology Therapy. Berlin: Springer-Verlag; 2006.