Quality of Life and Clinical Outcome After Anterior Cruciate Ligament Reconstruction Using Patellar Tendon Graft or Quadrupled Semitendinosus Graft
- 21 June 2010
- journal article
- research article
- Published by SAGE Publications in The American Journal of Sports Medicine
- Vol. 38 (8), 1533-1541
- https://doi.org/10.1177/0363546510369549
Abstract
Background: Randomized controlled trials after anterior cruciate ligament reconstructions with long-term follow-up including assessment of health-related quality of life are rare. Purpose: To compare clinical outcome and health-related quality of life 8 years after anterior cruciate ligament reconstruction using 2 types of graft. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Long-term follow-up of 164 patients with anterior cruciate ligament injury randomized to arthroscopic reconstruction with a quadrupled semitendinosus graft or a bone–patellar tendon–bone graft was undertaken. After a mean 8 years, 153 patients were available for follow-up, including instrumented laxity, 1-legged hop test, a knee-walking test, and assessment with International Knee Documentation Committee, Lysholm, Tegner, and patellofemoral pain score. Health-related quality of life was assessed with Knee Osteoarthritis Outcome Score and Short Form–36. Results: Patients in both graft groups retained the same stability, knee function, and health-related quality of life. The patellofemoral pain score was similar for both groups; the bone–patellar tendon–bone group had more donor site morbidity from kneeling and knee walking. In the bone–patellar tendon–bone group, 19 patients had no kneeling problems, 23 slight problems, 31 moderate problems, and 5 unable to kneel. Corresponding figures for the semitendinosus group were 25, 32, 16, and 2 (P < .001). Patients with early reconstructions (P = .008). Health-related quality of life regarding physical functioning in Short Form–36 was better for the early-reconstructed patients than for the later reconstructed (92 vs 85; P = .014). Patients without medial meniscal surgery had higher Knee Osteoarthritis Outcome Scores for all subscales than did patients with medial meniscal surgery, with most significant difference for sport and recreation (63 vs 75, P = .008). Conclusion: In the long term, the semitendinosus graft provided similar stability, knee function, and health-related quality of life but with less kneeling morbidity than did the bone–patellar tendon–bone graft.Keywords
This publication has 48 references indexed in Scilit:
- Development and preliminary validation of a scale to measure the psychological impact of returning to sport following anterior cruciate ligament reconstruction surgeryPhysical Therapy in Sport, 2007
- ACL ReconstructionClinical Orthopaedics & Related Research, 2007
- Long-term Outcome of Endoscopic Anterior Cruciate Ligament Reconstruction with Patellar Tendon AutograftThe American Journal of Sports Medicine, 2006
- Bone-patellar tendon-bone autografts versus hamstring autografts for reconstruction of anterior cruciate ligament: meta-analysisBMJ, 2006
- Hamstring Tendon versus Patellar Tendon Anterior Cruciate Ligament Reconstruction Using Biodegradable Interference Fit FixationThe American Journal of Sports Medicine, 2005
- High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injuryArthritis & Rheumatism, 2004
- There are differences in early morbidity after ACL reconstruction when comparing patellar tendon and semitendinosus tendon graftScandinavian Journal of Medicine & Science in Sports, 2001
- SF-36 Health Survey UpdateSpine, 2000
- Anterior Cruciate Ligament Reconstruction and the Long Term Incidence of GonarthrosisSports Medicine, 1999
- Knee osteoarthritis after meniscectomy: Prevalence of radiographic changes after twenty-one years, compared with matched controlsArthritis & Rheumatism, 1998