Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction: Comparison of Bone-Patellar Tendon-Bone Versus Hamstring Tendon Autograft
Tanarat Boonriong MD*, Niran Kietsiriroje MD*
Affiliation : * Department of Orthopaedic Surgery and Physical Medicine. Faculty of Medicine, Prince of Songkla University
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 tendon-
bone 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.
Materials and Methods : 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 post-
operative 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
