Patellar tendon or semitendinosus tendon autografts for anterior cruciate ligament reconstruction: a prospective, randomized study with a 7-Year follow-up

Abstract

Background: The aim of the study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using central-third bone-patellar tendon-bone (BTB) autografts and triple/quadruple semitendinosus (ST) autografts.

Hypothesis: In the long-term, ACL reconstruction using BTB autografts will render more donor-site problems than ST autografts.

Study design: Randomized controlled trial; Level of evidence, 1.

Methods: A randomized series of 71 patients (22 women and 49 men) with a unilateral ACL rupture who underwent reconstructive surgery were included in the study. The BTB graft was used in 34 patients (BTB group) and the ST-tendon graft was used in 37 patients (ST group). The patients were examined a median of 86 months (range, 68 to 114 months) after the reconstruction.

Results: Sixty-eight of 71 patients (96%) were examined at follow-up. The clinical assessments at follow-up revealed no significant differences between the BTB group and the ST group in terms of the Lysholm score, Tegner activity level, International Knee Documentation Committee evaluation system, 1-legged hop test, KT-1000 arthrometer laxity measurements, manual Lachman test, and range of motion. A significant improvement was seen in both groups compared with the preoperative values in terms of most clinical assessments. Donor-site morbidity in the form of knee-walking ability, kneeling ability, and area of disturbed anterior knee sensitivity revealed no significant differences between the groups.

Conclusion: Seven years after ACL reconstruction, the subjective and objective outcomes were similar after using the central-third BTB autograft and triple/quadruple ST autograft. Furthermore, no difference in terms of donor-site morbidity was found between the 2 groups.