A comparison of quadruple semitendinosus and patellar tendon grafts in reconstruction of the anterior cruciate ligament

In a two-centre study, 164 patients with unilateral instability of the ante rior cruciate ligament were prospectively randomised to arthroscopic recons truction with either a patellar tendon graft using interference screw fixat ion or a quadruple semitendinosus graft using an endobutton fixation techni que. The same postoperative rehabilitation protocol was used for all patien ts and follow-up at a median of 31 months (24 to 59) was carried out by ind ependent observers. Four patients (2%) were lost to follow-up. No significant differences were found between the groups regarding the Stry ker laxity test, one-leg hop test, Tegner activity level, Lysholm score, pa tellofemoral pain score, International Knee Documentation Committee (IKDC) score or visual analogue scale, reflecting patient satisfaction and knee fu nction. Slightly decreased extension, compared with the non-operated side, was found in the patellar tendon group (p < 0.05), Patients with associated meniscal injuries had lower IKDC, visual analogue (p < 0.01) and Lysholm s cores (p < 0.05) than those without such injuries, Patients in whom reconst ruction had been carried out less than five months after the injury had bet ter final IKDC scores than the more chronic cases (p < 0.05). We conclude that patellar tendon and quadruple semitendinous tendon grafts have similar outcomes in the medium term, Associated meniscal pathology sig nificantly affects the final outcome and early reconstruction seems to be b eneficial.