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No significant differences found between patellar tendon, hamstring autograft for ACL reconstruction
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BARCELONA — Patients who underwent ACL reconstruction using patellar tendon autografts showed “minor and mostly insignificant differences” during long-term follow-up compared with patients who received hamstring tendon autografts, according to a presenter at the European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress.
“[It] is our opinion that the graft choice facing reconstruction should be based on preference of the patient and the surgeon rather than any possible minor differences in the short, medium or long term,” Kristian Samuelsson, MD, PhD, MSC, of Sahlgrenska University Hospital in Gothenburg, Sweden, said in his presentation of the study, which won the ESSKA Theo van Rens Best Paper Award.
Kristian Samuelsson
Samuelsson and colleagues performed a 2-year follow-up of 193 patients from two previous randomized cohorts who underwent unilateral primary ACL reconstruction using either patellar tendon or hamstrings tendon autograft. Researchers performed a complete clinical assessment of patients, including knee laxity measurements, functional outcomes, patient-reported outcomes, activity scales and bilateral standing radiographs.
At a mean follow-up of 16.5 years, 147 patients were available with 61 patients in the patellar tendon group and 86 patients in the hamstring tendon group. Results showed no significant difference in range of motion of the reconstructed knee between the groups.
“The pivot shift test revealed less laxity in the [hamstring tendon] HT group when we removed the re-injured patients and patients with contralateral ACL injury,” Samuelsson said in his presentation. “However, it was almost non-significant. Otherwise, no difference was found in terms of Lachman, pivot-shift test and KT-1000.”
During the knee walking test, patients in the patellar tendon group experienced significantly more difficulties and had a larger area of disturbed anterior knee sensitivity, according to results. Researchers noted the two groups had no significant differences in terms of Lysholm knee scoring scale, Tegner activity scale and IKDC scores.
“The radiographic evaluation showed that both groups had significantly more postoperative radiographic changes,” Samuelsson said. “Their results were consistent, regardless of [the] classification system we used or whether patients with new ACL injury or contralateral injury were excluded, and there were no differences between the two groups.” – by Casey Tingle
Reference:
Samuelsson K, et al. Paper #AW01-1603. Presented at: European Society of Sports Traumatology, Knee Surgery and Arthroscopy Congress; May 4-7, 2016; Barcelona.
Disclosure: Samuelsson reports no relevant financial disclosures.