• Arch Orthop Trauma Surg · May 2024

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

    • Lee Yaari, Jonathan Singer, Dan Goldberg, Mustafa Yassin, Gabriel Agar, Dror Lindner, Yiftah Beer, and Barak Haviv.
    • Arthroscopy and Sports Injuries Unit, Orthopedic Department, Hasharon Hospital, Rabin Medical Center, Petach-Tikva, Israel.
    • Arch Orthop Trauma Surg. 2024 May 1; 144 (5): 218921952189-2195.

    PurposeTo 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.MethodsNinety-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.ResultsThe 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.ConclusionsVery 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.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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