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Bone-patellar tendon-bone and hamstring autografts show similar endoscopic ACL reconstruction results
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Bone-patellar tendon-bone and double-looped semitendinosus and gracilis autografts used in endoscopic ACL reconstruction performed for ligament rupture produced results that were not significantly different at short- and long-term follow-up, according to a researcher from Norway.
“Both groups presented satisfactory objective outcomes in [the] results,” Tone Gifstad, MD, at Trondheim University Hospital, in Trondheim, Norway, said when she presented the results. “There were no differences in anterior knee pain at the 7-year follow-up and there [was] inferior muscle strength in the injured knee compared to the uninjured knee in the hamstring [DLSG] group,” she said.
The investigators found bone-patellar tendon-bone (BPTB) grafts fixed with metal interference screws (Linvatec, Largo, Fla., USA) and double-looped semitendinosus and gracilis (DLSG) grafts fixed with the Bone Mulch Screw and WasherLoc device (Biomet, Warsaw, Ind., USA), proved successful for ACL reconstruction. They noted that one technique was not necessarily superior to another in their prospective randomized comparative study of 114 patients. In the study, results for 58 patients in the BPTB group were compared to 56 patients in the DLSG group at 1 year, 2 years and 7 years postoperatively.
Gifstad and colleagues found no significant differences for the Knee Injury and Osteoarthritis Outcome Scores, Tegner activity scores, mobility, anterior knee pain and Lysholm functional scores. Their comparison of the mean peak flexion torque and extension strength in the groups with either type of graft also yielded no significant differences in those parameters, according to the abstract.
Patients reported good or excellent knee function in 73% of cases in the BPTB group and 71% of cases in the DLSG group. Using the Lachman test and the KT-1000 arthrometer, researchers found no significant difference for laxity, according to the abstract.
Final results were obtained by examination or phone interview for 102 patients (89%), which showed that 19 patients in the DLSG group and 10 patients in the BPTB group eventually underwent subsequent procedures. Of those surgeries, three patients in the DLSG group and two patients in the BPTB group required ACL revisions, according to the abstract.
All patients followed the same postoperative rehabilitation programs, investigators noted. – by Jeff Craven
- References:
- Gifstad T. Paper #FP15-561. Presented at: European Society of Sports Traumatology Knee Surgery and Arthroscopy Congress; May 2-5, 2012; Geneva
- Gifstad T. Knee Surg Sports Traumatol Arthrosc. 2012; doi:10.1007/s00167-012-1947-0.
- For more information:
- Tone Gifstad, MD, can be reached at Trondheim University Hospital, Trondheim 7006, Norway; email: tgifstad@gmail.com.
Disclosure: Gifstad has no relevant financial disclosures.