Kim S.-J.,Gangdong Yonsei Sarang Hospital |
Yoon J.-Y.,Yonsei University |
Kim S.-M.,Yonsei Mucheoknaeun Hospital |
Ha S.,Modu Hospital |
And 2 more authors.
Arthroscopy - Journal of Arthroscopic and Related Surgery | Year: 2016
Purpose To evaluate and compare the clinical outcomes of anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone (BPTB) autograft and a patellar bone-tendon (PBT) autograft. Methods Seventy-nine patients who underwent ACL reconstruction using either a BPTB autograft or a PBT autograft were retrospectively evaluated. The minimum follow-up period was 24 months after surgery. A graft selection was determined by the patellar tendon length as measured on preoperative magnetic resonance imaging. If the patellar tendon length was longer than or equal to 45 mm, a PBT graft attached with the EndoPearl device was used. Fifty-one patients used BPTB autografts (group B) and 28 patients used PBT autografts (group P). The Lachman test, pivot-shift test, and anterior translation tested with a KT2000 arthrometer were assessed. Functional outcomes were assessed with the use of the Lysholm score, International Knee Documentation Committee subjective score, and objective grade. Anterior knee pain including kneeling pain was assessed with the use of the Shelbourne and Trumper questionnaire. Results There was no statistically significant difference between the 2 groups in the postoperative values of degree of anterior translation (P =.76), Lysholm score (P =.62), International Knee Documentation Committee subjective score (P =.91), and objective grade (P =.91). However, anterior knee pain assessed with the use of the Shelbourne and Trumper questionnaire (group B = 90 [range, 65 to 100], group P = 95 [range, 59 to 100], P =.02) and number of patients having kneeling pain (group B = 41%, group P = 18%, P =.04) differed significantly between the 2 groups. Conclusions ACL reconstruction using a PBT autograft provided reliable knee stability comparable to a BPTB autograft but with less kneeling pain. For patients who have a long patellar tendon that may cause graft-tunnel mismatch, a PBT can be an effective alternative graft option for arthroscopic ACL reconstruction. Level of Evidence Level III, retrospective comparative study. © 2016 Arthroscopy Association of North America.