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A prospective randomized comparison of bone-patellar tendon-bone and hamstring grafts for anterior cruciate ligament reconstruction

Journal article
Authors Gauti Laxdal
Jüri Kartus
L. Hansson
M. Heidvall
L. Ejerhed
Jón Karlsson
Published in Arthroscopy
Volume 21
Issue 1
Pages 34-42
ISSN 1526-3231 (Electronic)
Publication year 2005
Published at Institute of Surgical Sciences, Department of Orthopaedics
Pages 34-42
Language en
Keywords Adolescent, Adult, Anterior Cruciate Ligament/*injuries/*surgery, Child, Female, Follow-Up Studies, Humans, Male, Middle Aged, Orthopedic Procedures/methods, Patella/*surgery, Prospective Studies, Tendons/*transplantation
Subject categories Orthopaedics


PURPOSE: The aim of this study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using central-third, bone-patellar tendon-bone (BPTB group), 3-strand semitendinosus (ST group), or 4-strand semitendinosus/gracilis (ST/G group) autografts. TYPE OF STUDY: Prospective randomized trial. METHODS: A randomized series of 134 patients, all with unilateral ACL rupture was included in the study. In all 3 groups, interference screw fixation of the graft was used at both ends and 125 of 134 (93%) of the patients returned for the follow-up examination after 26 months (range, 20 to 43 months). The preoperative assessments in all 3 groups were similar in terms of gender, Tegner activity level, Lysholm score, KT-1000 measurements, 1-leg hop test, and the knee-walking test. RESULTS: At follow-up, the knee-walking test was significantly worse in the BPTB group than in the ST group (P = .0004) and ST/G group (P < .0001). Furthermore, the knee-walking test was significantly worse at follow-up than preoperatively in the BPTB group (P < .0001). The corresponding findings were not made in the other 2 groups. A significant reduction in knee laxity and an increase in activity level compared with the preoperative assessments were found in all 3 groups, without any significant differences between the groups. CONCLUSIONS: Two years after ACL reconstruction, the use of ST and ST/G autografts rendered significantly less discomfort during the knee-walking test than the use of BPTB autografts. However, in terms of functional outcome and knee laxity, the groups displayed no significant differences. LEVEL OF EVIDENCE: Level I.

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