A 7-year follow-up of patellar tendon and hamstring tendon grafts for arthroscopic anterior cruciate ligament reconstruction - Differences and similarities

被引:140
作者
Roe, J
Pinczewski, LA
Russell, VJ
Salmon, LJ
机构
[1] Australian Inst Musculoskeletal Res, Sydney, NSW 2065, Australia
[2] Castlereagh Imaging, Sydney, NSW, Australia
关键词
anterior cruciate ligament (ACL) reconstruction; hamstring tendon; patellar tendon; long term; clinical; longitudinal; prospective;
D O I
10.1177/0363546504274145
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
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.
引用
收藏
页码:1337 / 1345
页数:9
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