ANTERIOR CRUCIATE LIGAMENT GRAFT FIXATION - COMPARISON OF HAMSTRING AND PATELLAR TENDON GRAFTS

This study assessed the tensile properties of hamstring and patellar t endon anterior cruciate ligament reconstructions in older cadaveric kn ees (age range, 48 to 79 years). Mechanical testing to failure was con ducted by translating the tibia anteriorly at 1 mm/sec with the knee i n 200 of flexion. The strongest gracilis-semitendinosus graft fixation technique (103% of intact anterior cruciate ligament) had the tendons doubled and secured with soft tissue washers (P < 0.01). However, all reconstructions using gracilis-semitendinosus grafts were significant ly less stiff than the intact anterior cruciate ligament specimens reg ardless of fixation technique (P < 0.01). The highest strength patella r tendon graft fixation technique (84% of intact anterior cruciate lig ament) was obtained with a combination interference screw and suture t echnique. The difference in stiffness between a patellar tendon graft and an intact anterior cruciate ligament was not significant when inte rference screws were placed at both ends of the graft (P > 0.05). Both types of grafts failed most often on the tibial side. With appropriat e fixation, both grafts approximated the intact anterior cruciate liga ment in strength, but only patellar tendon grafts secured with interfe rence screws were comparable in stiffness.