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Patellar Tendon or Semitendinosus Tendon Autografts for Anterior Cruciate Ligament Reconstruction

A Prospective, Randomized Study With a 7-Year Follow-up

Mattias Lidén, MD^,*, Lars Ejerhed, MD, PhD, Ninni Sernert, RPT, PhD, Gauti Laxdal, MD and Jüri Kartus, MD, PhD

From the Department of Plastic Surgery, Sahlgrenska University Hospital, Göteborg, Sweden, the Department of Orthopaedics, Norra Älvsborg County Hospital, Trollhättan, Sweden, and the Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden

^* Address correspondence to Mattias Lidén, MD, Department of Plastic Surgery, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden (e-mail: mattias.liden{at}vgregion.se).

Background: The aim of the study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using central-third bone–patellar tendon–bone (BTB) autografts and triple/quadruple semitendinosus (ST) autografts.

Hypothesis: In the long-term, ACL reconstruction using BTB autografts will render more donor-site problems than ST autografts.

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

Methods: A randomized series of 71 patients (22 women and 49 men) with a unilateral ACL rupture who underwent reconstructive surgery were included in the study. The BTB graft was used in 34 patients (BTB group) and the ST-tendon graft was used in 37 patients (ST group). The patients were examined a median of 86 months (range, 68 to 114 months) after the reconstruction.

Results: Sixty-eight of 71 patients (96%) were examined at follow-up. The clinical assessments at follow-up revealed no significant differences between the BTB group and the ST group in terms of the Lysholm score, Tegner activity level, International Knee Documentation Committee evaluation system, 1-legged hop test, KT-1000 arthrometer laxity measurements, manual Lachman test, and range of motion. A significant improvement was seen in both groups compared with the preoperative values in terms of most clinical assessments. Donor-site morbidity in the form of knee-walking ability, kneeling ability, and area of disturbed anterior knee sensitivity revealed no significant differences between the groups.

Conclusion: Seven years after ACL reconstruction, the subjective and objective outcomes were similar after using the central-third BTB autograft and triple/quadruple ST autograft. Furthermore, no difference in terms of donor-site morbidity was found between the 2 groups.

Key Words: anterior cruciate ligament • patellar tendon • semitendinosus • autograft • surgery • randomized • prospective

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