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Comparing ACL Graft Repairs Using the Same Fixation Method

The purpose of this study was to compare two methods of anterior cruciate ligament (ACL) reconstruction. Many studies have been done using a patellar tendon versus hamstring tendon graft. This study is different. The surgeons used the same preparation of graft and method of repair for both types of graft.

In other studies the fixation method and procedures are different. The patellar tendon graft has a bone plug at each end. The hamstring tendon graft is made up of several strands of tendon without a piece of bone at the end. The method of fixing the graft to the bone varies.

In this study both grafts had a bony end. Both are put in place using screws. Everyone had the same rehab program after surgery. Patients were followed for at least five years and sometimes longer. Range of motion, strength, and pain were used as measures of results.

The authors report no difference in quadriceps strength between the two graft types. Hamstring strength was noted in the hamstring tendon group. Painful symptoms during kneeling were reported more often in the patellar tendon group. An equal number of patients in each group were able to return to their preinjury level of sports activity.

The goal in this study was to compare two types of ACL repair using the same fixation method. Severe kneeling pain was present with the patellar tendon graft. The hamstring graft in this study with a bone plug gave better knee stability compared to other studies using the hamstring graft without a bone plug.

The authors suggest further studies to compare the good and bad points of each type of ACL repair. There is a need to find a way to reduce problems with pain at the donor site. Hamstring tendon grafts are more complex to prepare than patellar tendon grafts. Ways to improve this problem are also needed.

References: Akio Matsumoto, MD, et al. A Comparison of Bone-Patellar Tendon-Bone and Bone-Hamstring Tendon-Bone Autografts for Anterior Cruciate Ligament Reconstruction. In The American Journal of Sports Medicine. February 2006. Vol. 34. No. 2. Pp. 213-219.

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