The 2 most frequently used autografts for anterior cruciate ligament
reconstruction are the bone-patellar tendon-bone and the quadrupled
hamstrings tendon.
Hypothesis
Hamstring tendon graft is superior to patellar tendon graft in restoring
tibial rotation during highly demanding activities because of its
superiority in strength and linear stiffness and because it is closer
morphologically to the anatomy of the natural anterior cruciate
ligament.
Study Design
Case control study; Level of evidence, 3.
Methods
Eleven patients with patellar tendon graft anterior cruciate ligament
reconstruction, 11 patients with hamstring tendon graft anterior cruciate
ligament reconstruction, and 11 controls were assessed. Kinematic data were
collected (50 Hz) with a 6-camera optoelectronic system while the subjects
descended stairs and, immediately after, pivoted on their landing leg. The
dependent variable examined was the tibial internal-external rotation during
pivoting. All patients in both groups were also assessed clinically and with
the use of a KT-1000 arthrometer to evaluate anterior tibial
translation.
Results
The results demonstrated that reconstructions with either graft successfully
restored anterior tibial translation. However, both anterior cruciate
ligament reconstruction groups had significantly increased tibial rotation
when compared with the controls, whereas no differences were found between
the 2 reconstructed groups.
Conclusion
The 2 most frequently used autografts for anterior cruciate ligament
reconstruction cannot restore tibial rotation to normal levels.
Clinical Relevance
New surgical techniques are needed that can better approximate the actual
anatomy and function of the anterior cruciate ligament.
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