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This Article Full Text Full Text (PDF) All Versions of this Article: 34/12/1933    most recent 0363546506290726v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (7) Citing Articles via Google Scholar Google Scholar Articles by Sajovic, M. Articles by Skaza, K. Search for Related Content PubMed PubMed Citation Articles by Sajovic, M. Articles by Skaza, K. Related Collections Reconstruction Graft fixation

A Prospective, Randomized Comparison of Semitendinosus and Gracilis Tendon Versus Patellar Tendon Autografts for Anterior Cruciate Ligament Reconstruction

Five-Year Follow-Up

Matjaz Sajovic, MD^*,, Vilibald Vengust, MD, Radko Komadina, MD, Rok Tavcar, MD and Katja Skaza, PT

From the General Hospital Celje, Celje, Slovenia, the University of Ljubljana, Ljubljana, Slovenia, and Rehabilitation Center Terme Zrece, Zrece, Slovenia

^* Address correspondence to Matjaz Sajovic, MD, Department of Orthopedics and Sports Trauma Surgery, General Hospital Celje, Oblakova 5, 3000 Celje, Slovenia (e-mail: sajovic{at}siol.com).

Background: There are still controversies about graft selection for primary anterior cruciate ligament reconstruction. Prospective randomized long-term studies are needed to determine the differences between the materials.

Hypothesis: Five years after anterior cruciate ligament reconstruction, there is a difference between hamstring and patellar tendon grafts in development of degenerative knee joint disease.

Study Design: Randomized controlled trial; Level of evidence, 1.

Methods: From June 1999 to March 2000, 64 patients were included in this prospective study. A single surgeon performed primary arthroscopically assisted anterior cruciate ligament reconstruction in an alternating sequence. In 32 patients, anterior cruciate ligament reconstruction was performed with hamstring tendon autograft, whereas in the other 32 patients, anterior cruciate ligament reconstruction was performed with patellar tendon autograft.

Results: At the 5-year follow-up, no statistically significant differences were seen with respect to the Lysholm score, clinical and KT-2000 arthrometer laxity testing, anterior knee pain, single-legged hop test, or International Knee Documentation Committee classification results; 23 patients (82%) in the hamstring tendon group and 23 patients (88%) in the patellar tendon group returned to their preinjury activity levels. Graft rupture occurred in 2 patients from the hamstring tendon group (7%) and in 2 patients from the patellar tendon group (8%). Grade B abnormal radiographic findings were seen in 50% (13/26) of patients in the patellar tendon group and in 17% (5/28) of patients in the hamstring tendon group (P = .012).

Conclusion: Both hamstring and patellar tendon grafts provided good subjective outcomes and objective stability at 5 years. No significant differences in the rate of graft failure were identified. Patients with patellar tendon grafts had a greater prevalence of osteoarthritis at 5 years after surgery.

Key Words: anterior cruciate ligament (ACL) reconstruction • hamstring tendons • semitendinosus and gracilis tendon • patellar tendon • cannulated interference screws • long-term clinical study

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