DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20175531

Comparative study of complications and final outcome between bone patellar tendon bone and hamstring auotgraft in ACL reconstruction

Gopal M. Shinde, Kusumchandra S. Ambhure, Yogesh Sharma, Manoj R. Kashid, S. K. Rai

Abstract


Background: The most common current graft choices in ACL reconstruction are the bone-patellar tendon–bone (BPTB) graft and the quadrupled Hamstring graft. Though BPTB is considered to be the gold standard; hamstring tendon (HT) grafts have increased in popularity over last decade. Our aim in this study is to assess the complications, comorbidities, difficulties and final outcome between BPTB and Hamstring grafts in ACL reconstruction.

Methods: 71 male patients with isolated tear of ACL between age group of 18-45 years were included in the study. 35 patients in group A underwent ACL reconstruction using bone patellar tendon bone autograft and 35 patients in group B were managed by reconstructing ACL using quadrupled Hamstring autograft. All the patients in both the groups were followed up at 08 weeks,06 months and 01 year post surgery and evaluated by Lysholm knee scoring system.

Results: The Lysholm scoring scale scores in anterior cruciate ligament reconstruction showed that BPTB group and Hamstring group have similar outcome. One case (2.8%) each of patellar fracture and graft contamination occurred in BPTB group. There were 09 cases of superficial infection of which 03 were from BPTB group and 06 were from Hamstring group.

Conclusions: There is statistically no significant difference in the overall clinical outcome between bone-patellar tendon- bone and Hamstring autografts. With precise surgical techniques, meticulous attention to sterility and proper wound closure most of the complications in both the techniques can be minimized or avoided.


Keywords


Bone patellar tendon bone autograft, Hamstring autograft, ACL reconstruction

Full Text:

PDF

References


Frank CB, Jackson DW. The science of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am. 1997;79:1556-76.

Bartlett R, Clatworthy M, Nguyen T. Graft selection in reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br. 2001;83:625- 34.

Gulotta LV, Rodeo SA. Biology of autograft and allograft healing in anterior cruciate ligament reconstruction. Clin Sports Med. 2007;26:509-24.

Brown CH Jr, Steiner ME, Carson EW. The use of hamstring tendons for anterior cruciate ligament reconstruction: technique and results. Clin Sports Med. 1993;12:723-56.

Corry IS, Webb JM, Clingeleffer AJ, Pinczewski LA. Arthroscopic reconstruction of the anterior cruciate ligament: a comparison of patellar tendon autograft and four-strand hamstring tendon autograft. Am J Sports Med. 1999;27:444-54.

Mohtadi NG, Chan DS, Dainty KN, Whelan DB. Patellar tendon versus hamstring tendon autograft for anterior cruciate ligament rupture in adults. Cochrane Database Syst Rev. 2011;9:CD005960.

Lee GH, McCulloch P, Cole BJ, Bush-Joseph CA, Bach BR Jr. The incidence of acute patellar tendon harvest complications for anterior cruciate ligament reconstruction. Arthroscopy. 2008;24:162-6.

Hantes ME, Basdekis GK, Varitimidiset SE, Giotikas D, Petinaki E, Malizos KN. Autograft Contamination During Preparation for Anterior Cruciate Ligament (American). J Bone Joint Surg. 2008;90:760-4.

Stien DA, Hunt SA, Rosen JE, Sherman OH. The incidence and outcome of patellar fractures after anterior cruciate ligament reconstruction. Arthroscopy. 2002;18:578-83.

Almazan A, Miguel A, Odor A, Ibarra JC. Intraoperative incidents and complications in primary arthroscopic anterior cruciate ligament reconstruction. Arthroscopy. 2006;22:1211-7.

Kim HJ, Lee HJ, Lee JC, Min SG, Kyung HS. Evaluation of Infection after Anterior Cruciate Ligament Reconstruction during a Short Period. Knee Surg Relat Res. 2017;29(1):45-51.

Judd D, Bottoni C, Kim D, Burke M, Hooker S. Infections following arthroscopic anterior cruciate ligament reconstruction. Arthroscopy. 2006;22:375–84.

Corry IS, Webb JM, Clingeleffer AJ, Pinczewski LA. Arthroscopic Reconstruction of the Anterior Cruciate Ligament A Comparison of Patellar Tendon Autograft and Four-Strand Hamstring Tendon Autograft. Am J Sports Med. 1999;27(4):444-54.

Aglietti P, Buzzi R, Zaccherotti G, De Biase P. Patellar tendon versus doubled semitendinosus and gracilis tendons for anterior cruciate ligament reconstruction. Am J Sports Med. 1994;22:211–8.

Eriksson K, Anderberg P, Hamberg P, Lofgren AC, Brandenburg M, Westman I, et al. A comparison of quadruple semitendinosus and patellar tendon grafts in reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br. 2001;83:348-54.