Abstract Presented at the 29th Annual Meeting of the Arthroscopy Association of North America| Volume 26, ISSUE 6, SUPPLEMENT , e21, June 2010

Bone-patellar Tendon-bone Autograft vs Hamstring Autograft Anterior Cruciate Ligament Reconstruction in the Young Athlete: A Retrospective Matched Analysis with 2 to 10 year Follow-up (SS-41)


      Patellar tendon and hamstring autografts are the most common graft choices in anterior cruciate ligament (ACL) reconstruction, but the ability of these grafts to return young athletes not just to activity, but to their previous level of play is still somewhat uncertain. This study sought to examine clinical and patient-reported outcomes as well as return to sport in athletes younger than 25 following ACL reconstruction with either patellar tendon (PT) or hamstring (HS) autografts using a matched-pairs case-control experimental design.


      Twenty-three matched pairs were obtained based on gender (56.5% Female), age (18.3 ± 2.5yrs PT vs.17.6 ± 2.6 HS), and length of follow-up (4.7 ± 2.1yrs PT vs. 4.2 ± 1.6 HS). All patients reported participating in very strenuous (soccer, basketball etc.) or strenuous (skiing, tennis etc.) sporting activity 4-7 times/week prior to their knee injury. Patient-reported outcomes included return to play data, the IKDC, SAS, ADLS, and SF-36 forms. Clinical outcomes included knee range of motion, laxity, and hop/jump testing.


      Most patients in both groups were able to participate in very strenuous or strenuous sporting activity at follow-up [18 (78.3%) PT vs. 19 (82.6%) HS]. However, only 13(56.5%) of the PT subjects and 10 (43.5%) of the HS patients were able to return to pre-injury activity levels in terms of frequency and type of sport (p=.63). HS patients showed higher ADLS (p<.01) and SAS (p<.01) scores and better restoration of extension (p<0.05).


      While both hamstring and patellar tendon graft types allow young athletes to return to some degree of strenuous or very strenuous sporting activity, only approximately half of all patients were able to return to their pre-injury level in terms of type and frequency of sport. Patellar tendon reconstruction may allow more patients to return to the same level of pre-injury sport, but hamstring grafts lead to better preservation of extension and higher patient-reported outcome scores.