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A 2-year follow-up of rehabilitation after ACL reconstruction using patellar tendon or hamstring tendon grafts: a prospective randomised outcome study

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

Abstract

Sixty-eight patients were clinically evaluated preoperatively, 3, 5, 7, 9 months, 1 and 2 years after ACL reconstruction, 34 with patellar tendon graft, 34 with hamstring graft. Outcome regarding graft choice and anterior knee laxity (P = 0.04) was in favour of patellar tendon graft. Hamstring graft led to a larger laxity, 2.4 mm compared with patellar tendon graft, 1.3 mm at 1 year and 2.5 mm and 1.5 mm, respectively, at 2 years (P = 0.05). There was a significant difference in rotational knee stability in favour of the patellar tendon graft at all test occasions but 9 months. A general effect regarding graft choice and muscle torque was found at 90°/s for quadriceps (P = 0.03) and hamstrings (P ≤ 0.0001) and at 230°/s for hamstrings (P ≤ 0.0001). No treatment effect regarding graft choice and one-leg hop test, postural sway or knee function was found. No group differences in anterior knee pain were found at any of the test occasions but 2 years in favour of hamstring graft compared to patellar tendon graft (P = 0.04). Patellar tendon graft resulted in higher activity level than hamstring graft at all test occasions but 1 year (P = 0.01). Patellar tendon ACL reconstruction led to more stable knees with less anterior knee laxity and less rotational instability than hamstring ACL reconstruction. Hamstring graft patients had not reached preoperative level in hamstring torque even 2 years after ACL reconstruction. Athletes with patellar tendon graft returned to sports earlier and at a higher level than those with hamstring graft.

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Acknowledgments

Funding for this study was provided, in part, by grants from the Swedish National Center for Research in Sports. We also gratefully thank all the patients for sharing their time with us.

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Authors and Affiliations

  1. Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 23100, 141 86, Huddinge, Sweden

    Annette Heijne

  2. Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research Center, Karolinska Institutet, Stockholm, Sweden

    Annette Heijne & Suzanne Werner

  3. Capio Artro Clinic, Stockholm, Sweden

    Suzanne Werner

  4. Sofiahemmet, Stockholm, Sweden

    Suzanne Werner

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  1. Annette Heijne
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Correspondence to Annette Heijne.

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Heijne, A., Werner, S. A 2-year follow-up of rehabilitation after ACL reconstruction using patellar tendon or hamstring tendon grafts: a prospective randomised outcome study. Knee Surg Sports Traumatol Arthrosc 18, 805–813 (2010). https://doi.org/10.1007/s00167-009-0961-3

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