A 7-Year Follow-up of Patellar Tendon and Hamstring Tendon Grafts for Arthroscopic Anterior Cruciate Ligament Reconstruction

• Published in: The American journal of sports medicine 2005-09, Vol.33 (9), p.1337
• Main Authors: Justin Roe, Leo A. Pinczewski, Vivianne J. Russell, Lucy J. Salmon, Tomomaro Kawamata, Melvin Chew
• Format: Article
• Language: eng ; jpn
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546504274145

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. Hypothesis: There is a difference between hamstring and patellar tendon grafts in the clinical results of anterior cruciate ligament reconstructions at 7 years. Study Design: 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. Keywords: anterior cruciate ligament (ACL) reconstruction hamstring tendon patellar tendon long term clinical longitudinal prospective