J Med Assoc Thai 2004; 87 (9):1100

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Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction: Comparison of Bone-Patellar Tendon-Bone Versus Hamstring Tendon Autograft
Boonriong T Mail, Kietsiriroje N

Background: The bone-patellar tendon-bone (BPTB) and the hamstring tendons are commonly used for arthroscopially-assisted anterior cruciate ligament(ACL) reconstruction.
Purpose: To compare the results of arthroscopically-assisted ACL reconstruction using bone-patellar tendonbone
and hamstring tendons grafts in terms of postoperative knee stability, knee functions and clinical rating scale, and patient satisfaction.
Hypothesis: There was no difference in the outcomes of the two grafts.
Study Design: Retrospective non-randomized clinical trial.
Material and Method: Two groups of patients, 45 in the BPTB group and 30 in the hamstring group, were followed for at least one year.
Results: The two groups had similar pre-operative data except the hamstring group which had a significantly
shorter duration of injury before operation (9.5 versus 18 months, p < 0.05). There was no difference in median pre-operative Lysholm knee score (74 in the BPTB group versus 75 in the hamstring group, p > 0.05) and the post-operative one (95 in the BPTB group versus 99 in the hamstring group, p > 0.05). There was also no difference in the median pre-operative HSS knee score (58 in the BPTB group versus 61 in the hamstring group, p > 0.05). Although there was a statistically significant difference in the median postoperative HSS knee score between the two groups (95 in the BPTB group versus 96 in the hamstring group,
p < 0.05), this was not clinically significant since both scores were rated as an excellent result. Both groups had a significantly improved knee stability and knee functions (Lysholm and HSS knee scores). The hamstring group, however, had significantly higher patient satisfaction (88% in the BPTB group versus 93% in the hamstring group, p < 0.05).
Conclusion: Both the BPTB and the hamstring tendon grafts resulted in significantly improved knee stability and functions with high patient satisfaction. The hamstring tendon group, however, had a significantly better post-operative patient satisfaction (Visual Analog Scale,VAS).

Keywords: Anterior cruciate ligament reconstruction, Bone-patellar tendon-bone, Hamstring tendon


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