Early post-operative morbidity following anterior cruciate ligament reconstruction: patellar tendon versus hamstring graft

This study documented postoperative morbidity during the first 4 months fol lowing anterior cruciate ligament (ACL) reconstruction using either patella r tendon or hamstring tendon autograft. Sixty-five patients undergoing prim ary arthroscopically assisted single-incision ACL reconstruction were rando mized to have a central third bone patellar tendon bone autograft (PT) or a doubled semitendinosus/doubled gracilis autograft (HS). Postoperatively pa tients undertook a standard 'accelerated' rehabilitation protocol. Patients were reviewed after 2 weeks, 8 weeks, and 4 months. At each review the loc ation and severity of general knee pain and the presence and severity of an terior knee pain (AKP) were recorded as were the presence and size of an ef fusion as well as the active and passive flexion and passive extension defi cits compared to the contralateral limb. Pain on kneeling, KT-1000 measured side to side difference in anterior tibial displacement, isokinetic assess ment of quadriceps and hamstring peak torque deficits, IKDC score and Cinci nnati sports activity level were also recorded after 4 months. After 2 week s more patients in the PT group complained of AKP and reported that the pai n was more severe. After 8 weeks there was no significant difference betwee n the groups for any variable. After 4 months the severity of general pain experienced and the incidence of pain on kneeling were greater in the PT gr oup. The PT group also demonstrated a significantly greater quadriceps peak torque deficit at 240 degrees /s. IKDC scores were higher in the HS group, but Cincinnati sports activity scores were higher in the PT group. Althoug h we observed a lower morbidity in the HS group, primarily related to pain, the severity of pain in both groups was relatively low and, in light of th e higher mean sports activity level observed in the PT group at 4 months th e clinical impact of the difference may not be significant.