SPORTS AND ALL DAY-LIFE ABILITY FOLLOWING ACL-RECONSTRUCTION BY USING THE HAMSTRINGS VS. THE BPT GRAFT

Abstract

Introduction: The goal of this prospective, randomized study is the functional evaluation of two different techniques of ACL reconstruction by using the bone-patella tendon (BPT) vs. hamstrings (ST/G).62 ACL-insufficient patients without any concommitent sport injuries took part in a prospective randomized study.

Material and Methods: Eighteen men and 13 women underwent ACL-reconstruction with BPT graft (Group I) with average age 29,87 (16–46) years. 31 patients (16 women and 15 men) with average age 34,23 (16–55) years underwent ACL-reconstruction using a quadrupled hamstrings graft (Group II). Both techniques were performed by using a press-fit and implant-free technique. We used the same accelerated rehabilitation protocol for both groups. The patients were evaluated by IKDC, Lysholm and Tegner scoring systems, KT 1000, one leg hop, isokinetics, internal torque, kneeling and knee walking test, 1 day preoperatively (VU), and 3 (NU I), 6 (NU II) and 12 months (NU III) postoperatively.

Results: One year postop.the results of Group II (30 patients classified as A and B) were according to IKDC scoring system better than those in Group I (Group I: 24 patients classified as A and B). We had similar results according to Lysholm-scoring evaluation (Group 11:95,61 points vs. 90,87 in Group I (p=0.017)) and Tegner-scoring (Group II: 7,07 vs. 6,61 in Group I (p=0.00)). According to the KT 1000 stability evaluation, there was no statistical significant difference between injured and uninjured knees in both groups. The evaluation of the strength of the hamstrings by isokinetics in both groups showed statistical significant differences (Group II: 90,34 Nm vs. 99,19 Nm in Group I, (p=0.008)). However, our results concerning internal torque evaluation were not statistical significant. The evaluation of one leg hop by comparing injured and non-injured leg showed a significant difference between group II and group I (Group II: 96% vs. 91% in Group I, (p=0.012)). We had worse results in Group I vs. Group II at kneelling and knee-walking-testings ((p=0.00)(p=0.00)), concerning the anterior knee pain.

Conclusion: From our results concerning IKDC, Lysholm, Tegner, kneeling and knee walking tests it seems that hamstrings can be recommended for ACL reconstruction. The isokinetic evaluation of hamstrings showed a statistical significant deficiency compaired to the BPT-group. But this result could not be confirmed with the internal torque evaluation and “one leg hop”-testing.