Arthroscopically assisted anterior cruciate ligament reconstruction: Comparison of bone-patellar tendon-bone versus semitendinosus gracilis autograft

Author(s): Dr. Ravikumar V, Dr. Jacob Mathew and Dr. Vaisak B

Abstract: Anterior cruciate ligament (ACL) tear is the most common serious ligamentous injury to the knee joint. The ACL is the primary stabilizer against anterior translation of the tibia on the femur and is important in counteracting rotation and valgus stress. Anterior cruciate ligament deficiency leads to knee instability. This results in recurrent injuries and increased risk of intra-articular damage, especially the meniscus. The goals of the ACL reconstruction are to restore stability to the knee: allow the patient to return to normal activities, including sports; and to delay the onset of osteoarthritis with associated recurrent injuries to the articular cartilage and loss of meniscal functions. The bone-patellar tendon-bone graft and the hamstring tendon graft are the two commonly used auto grafts for reconstruction. This study is to compare the results of arthroscopically assisted ACL Reconstruction using Bone-Patellar Tendon-Bone (PTB) and Semitendinosus-Gracilis (STG) grafts. This study was conducted in Govt. Medical College Kozhikode from March 2014 to October 2015. During this period 40 cases of adult patients with ACL deficient knees were selected according to the inclusion criteria. This study aims to compare the results of Arthoscopically assisted ACL Reconstruction using Bone –Patellar – Bone and STG tendon grafts in terms of Post operative knee stability, Subjective knee functions, Patient satisfaction, Graft site morbidity and Range of motion. Results of our study clearly showed that both bone patellar tendon bone and hamstring tendon grafts could effectively improve knee stability and functions after Anterior Cruciate Ligament reconstruction. At follow up evaluation, both groups had similar subjectives outcomes. The outcome for patients in this study undergoing ACL reconstruction with a Hamstring tendon graft did not differ from that of patients with a Patellar tendon graft in term of clinical stability, range of motion and general symptoms. The hamstring tendon group also had lower graft harvest site morbidly, as demonstrated by less kneeling pain at 6 months and 1 year.

DOI: https://doi.org/10.22271/ortho.2018.v4.i1h.79