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Primary anterior cruciate ligament reconstruction in athletes: a 5-year follow up comparing patellar tendon versus hamstring tendon autograft

5-Jahres-Ergebnisse nach primärer Rekonstruktion des vorderen Kreuzbandes bei Leistungssportlern: Bone-Tendon-Bone versus Semitendinosus-Gracilis-Plastik im Vergleich

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An Erratum to this article was published on 28 June 2014

Summary

Introduction

ACL reconstruction with quadruple hamstring graft (HT) as well as bone-patellar tendon-bone autograft (PT) is a frequent procedure in athletes after ACL rupture. Both techniques are reported to provide for satisfying results but only few articles compare both techniques.

Material and methods

Prospective evaluation was performed on 96 patients with isolated ACL rupture undergoing reconstruction with a HT or PT autograft by a single surgeon at our institution. Long time follow-up after five years included the IKDC and KOOS evaluation form as well as clinical assessment (ROM, Lachmann testing, KT-2000).

Results

Comparing both methods revealed no significant differences regarding IKDC and KOOS. The KT-2000 arthrometer testing showed a slightly increased mean laxity in the HT group. There were no differences regarding harvest side symptoms comparing HT and PT as well as one and two incision technique. Kneeling pain was significantly less common after HT autograft.

Summary

HT as well as PT autograft achieve equally good clinical results in athletes at five year follow-up with no significant difference regarding knee stability. Although no difference concerning the harvest site was identified, HT seems to be favorable for patients who work in a kneeling position.

Zusammenfassung

Hintergrund

Semitendinosus- und Gracilissehne (STG) als auch die Patellarsehne (BTB) sind gängige Transplantate zur Rekonstruktion des vorderen Kreuzbandes. Die Ergebnisse beider Techniken sind jeweils zufriedenstellend, jedoch gibt es nur wenige Arbeiten, die die Ergebnisse beider Methoden bei Leistungssportlern miteinander vergleichen.

Material und Methoden

96 Patienten mit isolierter vorderer Kreuzbandruptur wurden prospektiv randomisiert und in die Studie eingeschlossen. Die operative Versorgung der inkludierten Patienten mit STG- oder BTB-Transplantat erfolgte an einem Zentrum durch einen einzigen Operateur. Langzeituntersuchungen nach mindestens fünf Jahren schlossen den IKDC- und KOOS-Fragebogen sowie klinische Ergebnisse (ROM, Lachmann Test, KT-2000) ein.

Ergebnisse

Der Vergleich beider Methoden ergab keine signifikanten Unterschiede hinsichtlich KOOS und IKDC. Der instrumentelle Kniestabilitätstest KT-2000 ergab eine leichte erhöhte Laxizität bei Patienten der STG-Gruppe. Es gab keine signifikanten Unterschiede hinsichtlich Entnahmemorbidität im Vergleich, sowie im Vergleich zwischen der Singel- und Doppel-Inzisionstechnik. Schmerzen beim Knien traten signifikant seltener nach STG-Transplantat auf.

Zusammenfassung

Sowohl das STG- als auch BTB-Transplantat liefern vergleichbar gute klinische Ergebnisse in einem sportlich hoch aktiven Kollektiv mit einem Langzeit-Follow-up von zumindest fünf Jahren. Dabei ergab sich kein signifikanter Unterschied hinsichtlich Kniegelenks-Stabilität. Obwohl auch kein signifikanter Unterschied hinsichtlich Entnahmemorbidität vorliegt, scheint das STG Transplantat für Patienten in knienden Berufen vorteilhaft zu sein.

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Authors and Affiliations

  1. Department of Trauma Surgery, Medical University of Vienna, Waehringer Guertel 18–20, 1090, Wien, Austria

    Johannes Leitgeb MD, Julia Koettsdorfer MD, Rupert Schuster MD, Florian M. Kovar MD, Patrick Platzer MD & Silke Aldrian MD

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  1. Johannes Leitgeb MD
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  2. Julia Koettsdorfer MD
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  4. Florian M. Kovar MD
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Correspondence to Johannes Leitgeb MD.

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Leitgeb, J., Koettsdorfer, J., Schuster, R. et al. Primary anterior cruciate ligament reconstruction in athletes: a 5-year follow up comparing patellar tendon versus hamstring tendon autograft. Wien Klin Wochenschr 126, 397–402 (2014). https://doi.org/10.1007/s00508-014-0550-4

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