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Patellar Tendon and Semitendinosus Tendon Autografts for Anterior Cruciate Ligament (ACL) Repair Equally Safe for Donor Sites

Tearing or rupturing the anterior cruciate ligament (ACL) is a common knee injury, especially in people who participate in certain sports. Because the injury doesn't heal on its own, surgeons take some tissue from below the knee or the hamstring area and use this to repair the tear. Tissue taken from your own body to repair an injury is called an autograft.

Researchers wanted to compare the bone-patellar tendon-bone (BTB) autograft to the triple/quadruple semitendinosus (ST) autograft and the effects on the donor sites. The BTB autograft takes tissue from the tendon that connects the kneecap (patella) to the shin; the ST autograft takes the tissue from hamstrings (semitendinosus), found at the back of the thigh.

The researchers thought that the BTB autograft would cause more problems to the patients' donor site than the ST autograft. They recruited 71 patients with unilateral (one-sided) ACL ruptures to participate in this prospective, randomized trial. The patients would receive one of the two autografts and then would be followed for seven years. To ensure consistency in the surgical techniques, the same surgeon did all surgeries. All patients underwent the same rehabilitation: no weight-bearing on the repaired knee for six weeks, running was only permitted at three months, and contact sports at six month, at the earliest. Of the 71 original patients, 68 patients were followed to the end of the study.

When testing after the recovery, the researchers found that there were no significant differences between the two groups in any of the test findings. Patients in both groups were able to knee-walk, kneel, hop on the affected leg, and extend their leg equally well.

The authors point out that graft choice for ACL reconstruction is still controversial. However, because of the findings from this study, the researchers concluded that both techniques were reliable and provided equal patient outcome in both patient performance and activity level.

References: Mattias Liden, MD, et al. Patellar Tendon or Semitendinosus Tendon Autografts for Anterior Cruciate Ligament Reconstruction. A Prospective 7-year Follow-up. In The American Journal of Sports Medicine. May 2007. Vol. 35. No. 5. Pp. 740-748.

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