Does Autograft Choice Determine Intermediate-term Outcome of ACL Reconstruction?

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2010 Oct 19

PMID 20953764

Citations 55

Authors

Robert A Magnussen

James L Carey

Kurt P Spindler

Affiliations

Soon will be listed here.

Abstract

Purpose: Many clinical studies and systematic reviews have compared the short-term (2 years) outcomes of ACL reconstruction with hamstring and patellar tendon autograft. Few differences have been observed, with the exception of increased kneeling pain with patellar tendon grafts. The goal of this systematic review is to determine whether there are differences in clinical, patient-reported, or radiographic outcomes based on graft choice at a minimum of 5 years after ACL reconstruction.

Methods: A systematic review was performed to identify all prospective outcome studies comparing patellar tendon and hamstring autograft ACL reconstruction with minimum follow-up of at least 5 years. Seven studies were identified and meta-analysis of select data determined to be sufficiently homogenous was performed (failure and laxity).

Results: Five randomized controlled trials and two prospective cohorts comparing hamstring and patellar tendon autografts were identified. Clinical assessment [failure rate, International Knee Documentation Committee (IKDC) class, Lachman, pivot shift, and KT 1000 testing] showed no difference between grafts. Patient-reported outcomes (Lysholm, Cincinnati, and IKDC) showed no difference. Both anterior knee pain (3/3 studies) and kneeling pain (4/4 studies) were more frequent in the patellar tendon group. However, the patient-reported outcomes in these studies were not different. Radiographic evidence of osteoarthritis was inconsistent between autograft choices.

Conclusion: This level II systematic review demonstrates no difference in major clinical results between graft types with the exception of increased anterior knee and kneeling pain. There exists a potential for increased incidence of osteoarthritis in the patellar tendon group but increased sample size is required. These longer-term outcomes are similar to results of prior systematic reviews with two-year follow-up.

Citing Articles

Eighteen-year outcome of anterior cruciate ligament reconstruction with patellar tendon or hamstring autograft.

Yaari L, Singer J, Goldberg D, Yassin M, Agar G, Lindner D Arch Orthop Trauma Surg. 2024; 144(5):2189-2195.

PMID: 38630253 DOI: 10.1007/s00402-024-05317-2.

Postoperative considerations based on graft type after anterior cruciate ligament reconstruction a narrative review.

Leung A, DeSandis B, OBrien L, Hammoud S, Zarzycki R Ann Jt. 2024; 8:26.

PMID: 38529227 PMC: 10929311. DOI: 10.21037/aoj-22-51.

ACL Reconstruction With Quadriceps Soft Tissue Autograft Versus Bone-Patellar Tendon-Bone Autograft in Cutting and Pivoting Athletes: Outcomes at Minimum 2-Year Follow-up.

Renfree S, Brinkman J, Tummala S, Economopoulos K Orthop J Sports Med. 2023; 11(9):23259671231197400.

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Long-term results after anterior cruciate ligament reconstruction using patellar tendon versus hamstring tendon autograft with a minimum follow-up of 10 years-a systematic review.

Sollberger V, Korthaus A, Barg A, Pagenstert G Arch Orthop Trauma Surg. 2022; 143(7):4277-4289.

PMID: 36441213 PMC: 10293370. DOI: 10.1007/s00402-022-04687-9.

Cutoff Value for the Patient Acceptable Symptom State of the Thai IKDC Subjective Knee Form in Patients After Primary ACL Reconstruction.

Piamthipmanas T, Lertwanich P, Ganokroj P, Vanadurongwan B, Keyurapan E, Lamsam C Orthop J Sports Med. 2022; 10(8):23259671221113880.

PMID: 36003967 PMC: 9393576. DOI: 10.1177/23259671221113880.

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