From Reuters Health Information

Different Autografts Prompt Similar Results in ACL Repair

NEW YORK (Reuters Health) Jul 29 - Eleven years after joining a randomized trial, most patients who had anterior cruciate ligament (ACL) reconstruction were doing well regardless of whether their grafts came from the hamstring or the patellar tendon.

Subjective outcomes, objective stability, and graft failure rates were similar, according to Dr. Matjaz Sajovic and colleagues at the Institute of Public Health of the Republic of Slovenia, Ljubljana.

But the patellar tendon group did have a higher prevalence of osteoarthritis at 11 years, "which is the reason why I prefer the use of hamstring tendon autograft in most of my patients," Dr. Sajovic told Reuters Health by email.

Dr. Sajovic performed all of the original ACL reconstructions.

As reported online June 28th in The American Journal of Sports Medicine, he and his colleagues followed 64 patients who had been assigned to receive either semitendinosus and gracilis autografts (STG) or patellar tendon (PT) autografts.

Follow-up for 11 years in 54 patients showed no significant differences in Lysholm score and Short Form-36 (reflecting health-related quality of life), KT-1000 arthrometer laxity testing, anterior knee pain, single-legged hop test, or other measures.

Grafts ruptured in two STG patients (6%) and four PT patients (12%).

Eighty-one percent of STG patients and 72% of PT patients were at their preinjury levels of activity

The PT group, however, had more positive pivot-shift tests (+1). And 84% in that group had evidence of osteoarthritis affecting the knee, compared to 63% in the STG group - for reasons the authors can't explain.

"The results of our study," the authors conclude, "substantiate the similarities found in previous reports that document that good or excellent results may be obtained in the majority of ACL reconstructions when using either PT or STG autografts."

For further information: http://www.medscape.com/viewarticle/747289?src=mp&spon=8