No significant differences were seen at 5 years in the quality of life outcomes for patients who underwent patellar tendon, hamstring tendon and double-bundle techniques for ACL reconstruction, according to recently published results.
In a randomized controlled trial of patients with ACL deficiency, 110 patients were assigned to anatomically positioned ACL reconstruction with use of a patellar tendon graft, 110 patients were assigned to a quadruple-stranded hamstring tendon construct and 110 patients were assigned to a double-bundle hamstring tendon construct. The ACL-quality of life (QOL) score was the 5-year primary outcome measure. Other outcomes included the IKDC subjective score and objective grades, pivot shift assessment, range of motion, kneeling pain, Tegner activity scale, Cincinnati Occupational Rating Scale, complete traumatic re-ruptures, partial traumatic tears, total traumatic re-injuries and atraumatic graft failures.
Results showed the ACL-QOL scores significantly increased in the three groups. However, at 5 years, the ACL-QOL was not different between the groups. The mean ACL-QOL for patellar tendon, hamstring tendon and double-bundle was 82.5, 83.9 and 81, respectively. Investigators noted the proportion of patients with a pivot shift grade of 2 or more at 5 years and normal and nearly normal knees per IKDC grade was greater in patients who underwent patellar tendon reconstruction. Groups were not significantly different with regard to IKDC subjective scores knee range of motion, which included passive extension deficits, the single-leg hop test, Cincinnati Occupational Rating scores and Tegner activity levels.
Patients who underwent patellar tendon reconstruction were more likely to experience kneeling pain, whereas patients who underwent hamstring tendon and double-bundle reconstructions had more complete traumatic re-ruptures and partial traumatic tears. Significantly fewer combined traumatic re-injuries were seen in patients who underwent surgery with the patellar tendon graft. Overall, 10% of patients had atraumatic graft failure. – by Monica Jaramillo
Disclosures: The authors report no relevant financial disclosures.