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Eighteen-year outcome of anterior cruciate ligament reconstruction with patellar tendon or hamstring autograft

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

To evaluate patient reported outcomes and radiographic arthritic changes of transtibial anterior cruciate ligament reconstruction (ACLR) with either bone-patellar tendon-bone (BPTB) or hamstrings (HS) auto-grafts at a minimum of 15-year follow-up.

Methods

Ninety-four patients (51 of the HS group, 43 of BPTB group) who were operated between the years 2000 to 2005 in two tertiary referral hospitals were contacted and invited to a retrospective evaluation. The interview included subjective outcomes using the Lysholm knee scoring questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Tegner activity level scale, Visual Analogue Scale (VAS) for pain and patients’ satisfaction scale. Knee examination included measurements of motion and stability. Knee radiographs were evaluated for osteoarthritic changes according to the Kellgren-Lawrence (KL) score.

Results

The average evaluation time from surgery was 18.6 years. Subjectively, there was no significant difference between groups except for a better post-operative level of activity and satisfaction in the HS group. Objectively, there was no significant difference between groups in knee stability and range of motion. Most patients had grade KL ≤ 1 radiographic osteoarthritits changes and there was no significant difference between groups. Recurrent complete tear of the reconstructed graft occurred in 3 patients of each group. In both groups 84% had no further surgery while the indications for further surgery were mostly a meniscal tear or tibial hardware removal.

Conclusions

Very long-term outcomes and clinical stability of transtibial HS or BPTB graft ACL reconstruction are good with low rate of graft failure and radiographic osteoarthritis.

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Data availability

This manuscript has associated data in a data repository available on request from the corresponding author.

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Author notes

  1. Lee Yaari and Jonathan Singer are equally contributed first authors. Barak Haviv and Yiftah Beer are equally contributed last authors.

Authors and Affiliations

  1. Arthroscopy and Sports Injuries Unit, Hasharon Hospital, Rabin Medical Center, 7 Keren Kayemet St, Petach-Tikva, 49372, Israel

    Barak Haviv

  2. Arthroscopy and Sports Injuries Unit, Orthopedic Department, Hasharon Hospital, Rabin Medical Center, Petach-Tikva, Israel

    Lee Yaari, Mustafa Yassin & Barak Haviv

  3. Arthroscopy and Sports Injuries Unit, Orthopedic Division, Assaf Harofeh-Shamir Medical Center, Tzrifin, Israel

    Jonathan Singer, Gabriel Agar, Dror Lindner & Yiftah Beer

  4. Orthopedic Department, Faculty of Medical & Health Sciences, Tel-Aviv University, Tel Aviv, Israel

    Lee Yaari, Jonathan Singer, Dan Goldberg, Mustafa Yassin, Gabriel Agar, Dror Lindner, Yiftah Beer & Barak Haviv

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Contributions

All authors: conceptualization, data curation, writing – review and editing, project administration. Lee Yaari, Jonathan Singer, Dan Goldberg: methodology, formal analysis, investigation. Barak Haviv, Yiftah Beer: writing-original draft, supervision.

Ethical approval

The study was approved by an institutional review board of Rabin Medical Center, Israel: number 0277-20-RMC.

Corresponding author

Correspondence to Barak Haviv.

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Yaari, L., Singer, J., Goldberg, D. et al. Eighteen-year outcome of anterior cruciate ligament reconstruction with patellar tendon or hamstring autograft. Arch Orthop Trauma Surg (2024). https://doi.org/10.1007/s00402-024-05317-2

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