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Anterior cruciate ligament reconstruction with bone–patellar tendon–bone graft is associated with higher and earlier return to sports as compared to hamstring tendon graft

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To study the effect of age, duration of injury, type of graft and concomitant knee injuries on return to sports after anterior cruciate ligament (ACL) reconstruction.

Method

One-hundred and sixteen athletes underwent ACL reconstruction using either bone–patellar tendon–bone graft (BPTB; n = 58) or semitendinosus-gracilis graft (n = 58), depending upon their random number sequences. Five variables were analyzed in terms of their effect on return to sports-age, type of graft, time interval between injury and surgery, chondral damage and meniscal tears.

Results

Fifty-three out of 73 (72.6%) athletes aged between 16 and 25 years and 21/43 (49%) athletes aged between 25 and 40 years returned to sports (p = 0.02). The mean time to return to sports was 9.7 ± 2.1 months and 10.8 ± 1.7 months in athletes aged < 25 years and 25–40 years, respectively (p = 0.04). ACL reconstruction with BPTB graft (43/58) was associated with higher rate of return to sports as compared to hamstring tendon graft (31/58; p = 0.02). The mean duration of return to sports with BPTB and STGPI graft was 9.7 ± 2.0 months and 10.7 ± 2.0 months, respectively (p = 0.02). 29/36 (80.5%) patients operated between 2 and 6 months, 18/29 (62%) operated in < 2 months, and 27/51 (53%) operated after 6 months of injury had returned to sports (p = 0.03). Athletes who were operated within 2 months of the injury were the earliest to return to sports (9.4 ± 2.1 months), followed by those operated within 2–6 months (9.9 ± 1.9 months) and lastly by the ones operated after 6 months of the injury (10.9 ± 2.1 months; p = 0.04).

Conclusions

The rate of return to sports was observed to be higher in athletes younger than 25 years as compared to older athletes (> 25 years). ACL reconstruction with BPTB graft was associated with higher and earlier returns to sports as compared to hamstring graft. The rate of return to sports was highest if surgery was performed between 2 and 6 months after the injury.

Level of evidence

III.

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Authors and Affiliations

  1. Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India

    Ravi Gupta, Anil Kapoor, Ashwani soni, Sourabh Khatri & Gladson David Masih

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  1. Ravi Gupta
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  2. Anil Kapoor
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  3. Ashwani soni
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  4. Sourabh Khatri
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  5. Gladson David Masih
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Correspondence to Anil Kapoor.

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This study was performed according to ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments.

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Gupta, R., Kapoor, A., soni, A. et al. Anterior cruciate ligament reconstruction with bone–patellar tendon–bone graft is associated with higher and earlier return to sports as compared to hamstring tendon graft . Knee Surg Sports Traumatol Arthrosc 28, 3659–3665 (2020). https://doi.org/10.1007/s00167-020-06074-6

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