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COMPARATIVE RANDOMISED STUDY COMPARING TWO TECHNIQUES FOR ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT PLASTY: PATELLAR TENDON VERSUS HAMSTRING



Abstract

Purpose of the study: The objective was to compare the results of ligamentoplasties with two commonly used grafts, hamstring and patellar tendon. This was a prospective randomized study.

Material and methods: Between January 2001 and June 2004, 98 patients with an acute or chronic anterior cruciate ligament (ACL) tear with joint instability were included in this randomized study for arthroscopic repair. Patients were randomized to the patellar or hamstring arm. Clinical assessment was based on laxity, IKDC score, Lyscholm score, pain visual analog scale (VAS), midthigh thickness and isokinetic assessment at three months. Measurements were recorded preoperatively and at 1, 3, 6 weeks and 3, 6, and 12 months.

Results: The two groups were comparable regarding gender, morphotype, associated lesions, and activity level. There was no difference in operative time or in recovery of complete extension. Anterior laxity was the same in the two groups. The isokinetic deficit appeared to be greater in the bone-tendon-bone group at three months. The IKDC and Lysholm scores were not significantly different at six and twelve months. Harvesting site morbidity was more pronounced in the bone-tendon-bone group.

Conclusion: The two techniques provide good results. The bone-tendon-bone technique appears to cause greater harvesting site morbidity. While the isokinetic results appear to be better in the hamstring group, the measurements of laxity and recovery of stability did not show any difference.

Correspondence should be addressed to SOFCOT, 56 rue Boissonade, 75014 Paris, France.