Semitendinosus tendon vs. patellar ligament - clinical results after reconstruction of the ACL

The aim of our prospective randomised study was to evaluate the clinical re sults after arthroscopical reconstruction of the ACL using the midthird pat ellar ligament or semitendinosus tendon. Methods. Forty patients were followed up two years postoperatively. Twenty of them received either a patellar ligament graft (BTB-group) or doubled se miteninosus tendon (SET-group),The clinical evaluation included the preoper ative and two years postoperative assessment, based on the IKDC-Score,Tegen er-Score and Mc-Carroll-Score. The a.p.-translation was evaluated using the KT-1000. Results. Sixteen (80%) patients of the SET-group and 10 (50%) patients of t he BTB-group showed good and excellent results in the over all assessment w ith the IKDC-Score. The mean side to side KT-1000 difference yielded 1.6 mm (-2-4 mm) in the BTB-group and 2.7 mm (0-7 mm) in the SET-group (p<0.05). The retropatellar pain syndrome based on the Mc-Carroll-Score showed 17.4 p oints in the BTB-group in comparison to 19.5 points in the SET-group (p<0.0 5) The level of activity using the Tegner-score showed preoperatively for b oth the SET- and BTB-group 6.9 points and postoperatively for the SET-group 6.7 points and for the BTB-group 5.6 points. Conclusions. Despite the inferior a.p.-stability for the patients who recei ved doubled semitendinosus tendon grafts they presented clinically superior results compared to the BTB-group. Therefore this technique seems to be th e alternative method. In order to improve the stability we recommend the us age of three or four stranded grafts and an improved fixation technique.