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Choice of ACL Graft Important

Many studies have been done comparing the two methods of anterior cruciate ligament (ACL) repair. Good to excellent results are reported with both the patellar tendon graft and the hamstring graft methods.

This five-year study is one of the longest known follow-up periods comparing the results of these two ACL procedures. All operations were done by the same surgeon during this period. Surgical technique for graft fixation used was the same throughout. All patients followed the same prescribed rehab program.

The major finding of this study was the increased number of patients with osteoarthritis (OA). OA was seen five years after ACL repairs using the patellar tendon graft method. A second finding reported was that permanent loss of knee extension can be avoided with an aggressive rehab program.

Other measures of results such as pain, function, and motion were equal between the two groups. But 50 per cent of the patellar tendon group showed X-ray changes. These changes included joint narrowing and bone spurs called osteophytes.

The results of this study confirm that the choice of ACL graft can affect the joint later. The authors say these results were not influenced by meniscectomy (cartilage removal) because the hamstring group had more meniscectomies and less OA than the patellar group.

References: Matjaz Sajovic, MD, et al. A Prospective, Randomized Comparison of Semitendinosus and Gracilis Tendon Versus Patellar Tendon Autografts for Anterior Cruciate Ligament Reconstruction. Five-Year Follow-Up. In The American Journal of Sports Medicine. December 2006. Vol. 34. No. 12. Pp. 1933-1940.

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