Return to pivot-contact sports after anterior cruciate ligament reconstruction: Patellar tendon or hamstring autografts

Purpose of the study. - The purpose of this study was to compare outcome at 12 months and return of pivot-contact sports in male subjects having undergone anterior cruciate ligament reconstruction using a patellar tendon or four-strand hamstring autografts. Material and methods. - Sixty mate athletes underwent arthroscopic ligament reconstruction using either a patellar graft or a hamstring graft. The two groups were comparable for age (25 +/- 6 years), height (1177 +/- 5 cm), weight (74 +/- 8 kg), pivot-contact sports, and level of sports activity. The two groups were reviewed at four, six and 12 months. The Lysholm and Tegner scores were noted and isokinetic tests were performed (60 and 180 degrees/s). The comparison was completed at twelve months with the single-legged hop test, instrumental laximetry (KT-1000(R)) and the Arpege and IKDC 2000 scores. Return to pivot-contact sports at the same level was assessed at last follow-up after having been encouraged at the nine-month check-up. Results. - At twelve months, the function scores (IKDC 2000, Lysholm: 99.4 5 versus 98 5, Tegner: 6.8 +/- 1 versus 6.5 +/- 1) and single-legged hop test (94 +/- 5% versus 95 +/- 7%) were comparable. Instrumental laxity measurements however demonstrated greater laxity with the hamstring graft (2.7 +/- 0.4mm versus 1.8 +/- 0.3mm, p=0.02). A knee extension deficit was observed for the patellar technique (10 +/- 8%, p<0.01). A knee flexion deficit was observed for the hamstring technique (11 +/- 14%, p<0.01). Return to pivot-contact sports at the same level was comparable and concerned 53% [95%CI 41-66] of the knees after hamstring ligament reconstruction and 56.6% [44-68] of the knees after patellar ligamentoplasty. Conclusion. - The two techniques of anterior cruciate ligament reconstruction were found to be equivalent in terms of return to pivot-contact sports at the same level. It was noted however that this resumed sports activity was possible for only one out of two subjects despite the systematic medical and surgical surveillance and selection of subjects free of any complication. (C) 2007 Elsevier Masson SAS. Tous droits reserves.