Four-strand hamstring tendon autograft compared with patellar tendon-bone autograft for anterior cruciate ligament reconstruction - A randomized study with two-year follow-up

Seventy-two patients with subacute or chronic rupture of the anterior cruci ate ligament were randomly assigned to autograft reconstruction with four-s trand gracilis and semitendinosus tendon (N = 37) or with patellar tendon-b one (N = 35) from the ipsilateral side. The groups were similar in terms of age, sex, level of activity, degree of laxity, meniscal lesions found surg ically, and rehabilitation program. The follow-up was performed at another hospital by independent observers after 6, 12, and 24 months. Sixty-one pat ients (32 with hamstring tendon grafts and 29 with patellar tendon grafts) complied with the follow-up routine for the full 24 months. No differences were found between the groups with respect to Cincinnati functional score, KT-1000 arthrometer measurements, or stairs hopple test results. The subjec tive result and the single-legged hop test result were better for the hamst ring tendon group after 6 and 12 months, but no differences were found afte r 24 months. The hamstring tendon group showed better isokinetic knee exten sion strength than did the patellar tendon group after 6 months, but not af ter 12 and 24 months. There was a significant weakness in isokinetic knee f lexion strength among the hamstring tendon group. Anterior knee pain was no t significantly different between the groups, but kneeling pain was signifi cantly less common in the hamstring tendon group after 24 months.