BACKGROUND: The choice of different graft types and surgical techniques used when reconstructing a torn anterior cruciate ligament may influence the long-term prevalence of osteoarthritis and functional outcomes. HYPOTHESIS: There are no differences in the prevalence of knee osteoarthritis or knee function in patients undergoing reconstruction of a torn anterior cruciate ligament with4-strand hamstring autograft versus patellar tendon-bone autograft. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS:Seventy-two patients with subacute or chronic rupture of the anterior cruciate ligament were randomly assigned to autograft reconstruction with 4-strand gracilis and semitendinosus tendon (HAM) (N = 37) or with patellar tendon-bone (PTB) (N = 35) from the ipsilateral side. Outcome measurements were the Cincinnati knee score, single-legged hop tests, isokinetic muscle strength tests, pain, knee joint laxity test (KT-1000 arthrometer), and a radiologic evaluation (Kellgren and Lawrence) at 10-year follow-up. RESULTS:At 10 years, 57 patients (79%) were eligible for evaluation-29 in the HAM group and 28 in the PTB group. No differences were found between the 2 graft groups with respect to the Cincinnati knee score, the single-legged hop tests, pain, muscle strength measurements, or knee joint laxity. Fifty-five percent and 64% of the patients had osteoarthritis corresponding to Kellgren and Lawrence grade 2 or more in the HAM and the PTB groups, respectively (P =.27). For the uninvolved knee, the corresponding numbers were 28% and 22% (P = .62). CONCLUSION: At 10 years postoperatively, no statistically significant differences in clinical outcome between the 2 graft types were found. The prevalence of osteoarthritis was significantly higher in the operated leg than in the contralateral leg, but there were no significant differences between the 2 groups. The results indicate that the choice of graft type after an anterior cruciate ligament injury has minimal influence on the prevalence of osteoarthritis 10 years after surgery.
RCT Entities:
BACKGROUND: The choice of different graft types and surgical techniques used when reconstructing a torn anterior cruciate ligament may influence the long-term prevalence of osteoarthritis and functional outcomes. HYPOTHESIS: There are no differences in the prevalence of knee osteoarthritis or knee function in patients undergoing reconstruction of a torn anterior cruciate ligament with 4-strand hamstring autograft versus patellar tendon-bone autograft. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: Seventy-two patients with subacute or chronic rupture of the anterior cruciate ligament were randomly assigned to autograft reconstruction with 4-strand gracilis and semitendinosus tendon (HAM) (N = 37) or with patellar tendon-bone (PTB) (N = 35) from the ipsilateral side. Outcome measurements were the Cincinnati knee score, single-legged hop tests, isokinetic muscle strength tests, pain, knee joint laxity test (KT-1000 arthrometer), and a radiologic evaluation (Kellgren and Lawrence) at 10-year follow-up. RESULTS: At 10 years, 57 patients (79%) were eligible for evaluation-29 in the HAM group and 28 in the PTB group. No differences were found between the 2 graft groups with respect to the Cincinnati knee score, the single-legged hop tests, pain, muscle strength measurements, or knee joint laxity. Fifty-five percent and 64% of the patients had osteoarthritis corresponding to Kellgren and Lawrence grade 2 or more in the HAM and the PTB groups, respectively (P =.27). For the uninvolved knee, the corresponding numbers were 28% and 22% (P = .62). CONCLUSION: At 10 years postoperatively, no statistically significant differences in clinical outcome between the 2 graft types were found. The prevalence of osteoarthritis was significantly higher in the operated leg than in the contralateral leg, but there were no significant differences between the 2 groups. The results indicate that the choice of graft type after an anterior cruciate ligament injury has minimal influence on the prevalence of osteoarthritis 10 years after surgery.
Authors: Károly Schandl; Dénes B Horváthy; Attila Doros; Ernő Majzik; Charlotte M Schwarz; Lajos Csönge; Géza Abkarovits; László Bucsi; Zsombor Lacza Journal: Int Orthop Date: 2016-06-29 Impact factor: 3.075
Authors: David Bahlau; Henri Favreau; David Eichler; Sébastien Lustig; François Bonnomet; Matthieu Ehlinger Journal: Int Orthop Date: 2019-08-24 Impact factor: 3.075
Authors: Kurt P Spindler; Laura J Huston; Kevin M Chagin; Michael W Kattan; Emily K Reinke; Annunziato Amendola; Jack T Andrish; Robert H Brophy; Charles L Cox; Warren R Dunn; David C Flanigan; Morgan H Jones; Christopher C Kaeding; Robert A Magnussen; Robert G Marx; Matthew J Matava; Eric C McCarty; Richard D Parker; Angela D Pedroza; Armando F Vidal; Michelle L Wolcott; Brian R Wolf; Rick W Wright Journal: Am J Sports Med Date: 2018-03 Impact factor: 6.202