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Bone-patellar tendon-bone autograft versus hamstring autograft anterior cruciate ligament reconstruction in the young athlete: a retrospective matched analysis with 2–10 year follow-up

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study was to examine clinical and patient-reported outcomes as well as return to sport in athletes younger than 25 following ACL reconstruction with either bone-patellar tendon-bone (BTB) or hamstring (HS) autografts using a matched-pairs case–control experimental design.

Methods

Twenty-three matched pairs were obtained based on gender (57% women), age (18 ± 3 years BTB vs. 18 ± 3 HS), and length of follow-up (5 ± 2 years BTB vs. 4 ± 2 HS). Patients reported participating in very strenuous (soccer, basketball, etc.) or strenuous (skiing, tennis, etc.) sporting activity 4–7 times/week prior to their knee injury. Patient-reported outcomes included return to play data, the IKDC, SAS, ADLS, and SF-36 forms. Clinical outcomes included knee range of motion, laxity, and hop/jump testing.

Results

The majority of patients in both groups were able to participate in very strenuous or strenuous sporting activity 4–7 times per week following surgery [17 (74%) BTB vs. 16 (70%) HS]. However, only 13 (57%) of the BTB subjects and 10 (44%) of the HS patients were able to return to pre-injury activity levels (P = n.s.). HS patients showed higher ADLS (P < 0.01) and SAS (P < 0.01) scores, better restoration of extension (P < 0.05), and less radiographic evidence of osteoarthritis (P < 0.05).

Conclusions

Hamstring and bone-patellar tendon-bone autografts allow approximately 70% of young athletes to return to some degree of strenuous or very strenuous sporting activity, while only approximately half of patients were able to return to their pre-injury sporting activity level. Hamstring grafts lead to better preservation of extension, higher patient-reported outcome scores, and less radiographic evidence of osteoarthritis.

Level of evidence

Therapeutic (case–control study) Level III.

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Authors and Affiliations

  1. Section of Orthopaedic Surgery, University of Manitoba, AD4-820 Sherbrook Street, Winnipeg, MB, R3A 1R9, Canada

    Randy Mascarenhas

  2. Lake Erie College of Osteopathic Medicine, Erie, PA, USA

    Michael J. Tranovich

  3. Temple University Orthopaedics and Sports Medicine, Philadelphia, PA, USA

    Eric J. Kropf

  4. Division of Sports Medicine, Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Freddie H. Fu & Christopher D. Harner

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  1. Randy Mascarenhas
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  2. Michael J. Tranovich
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  3. Eric J. Kropf
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  4. Freddie H. Fu
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  5. Christopher D. Harner
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Correspondence to Randy Mascarenhas.

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Mascarenhas, R., Tranovich, M.J., Kropf, E.J. et al. Bone-patellar tendon-bone autograft versus hamstring autograft anterior cruciate ligament reconstruction in the young athlete: a retrospective matched analysis with 2–10 year follow-up. Knee Surg Sports Traumatol Arthrosc 20, 1520–1527 (2012). https://doi.org/10.1007/s00167-011-1735-2

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