Comparison of Bone-Patellar Tendon-Bone Grafts with Four-Strand Hamstring Grafts for Anterior Cruciate Ligament Reconstruction

The choice of graft for anterior cruciate ligament ACL reconstruction remains controversial. This study aimed to compare clinical results of bone-patellar tendon-bone (BPTB) grafts and four-strand semitendinosus-gracilis grafts for ACL reconstruction over a 3 year follow-up interval. In a randomized clinical trial study، 71 patients with an average age of 29 years were treated for ACL between 2008 and 2009. Forty six patients underwent reconstruction with BPTB autograft، and 41 were treated with ST autograft. In the last year of follow-up، 37 patients in patella group and 34 patients in hamstring group were evaluated in terms of return to pre-injury activity level، pain، knee stability، range of motion، IKDC score and complications. At 36 month follow-up، 34 patients in BPTB and and 28 in ST group، had good-to-excellent IKDC score (p≥. 05). Lachman test was graded normal، for 23 while patients in BPTB and / in ST group، (p=. 043) normal pivot-shift test was present in، 29 and 15 patients، respectively (p=. 038). There was no significant difference in terms of thigh circumference knee effusion، range of motion or pain. The complications rate was also similar. These results indicate a trend toward increased graft laxity and pivot-shift grades in patients undergoing reconstruction with hamstring autograft compared with patella tendon. However، the two groups had comparable results in terms of activity level، and knee function.