SUMMARY
Background. There is no consensus in the current literature on which surgical options render the best long-term results after ACL reconstruction in terms of clinical outcomes and development of radiographic osteoarthritis (AO).
The aim of this study is to investigate clinical and radiological results at long-term follow up after ACL reconstruction using hamstring tendons autograft (Group HT), hamstrings autograft with extra-articular reconstruction (Group HT-ER), and bone patellar tendon bone autograft (Group BPTB).
Methods. All patients were evaluated at final follow-up using Lysholm, International Knee Documentation Committee (IKDC), and Tegner scores. An arthrometric KT-1000 evaluation was also done. Comparative weight bearing radiographs were taken, including a skyline view for patellofemoral joint and analyzed according to Fairbank, Kellgren, and IKDC classification.
Sixty patients were selected for this retrospective study, 20 for each group. The minimum final follow-up was 10 years for each group. All patients were male and involved in sport activities (Tegner pre-injury >7).
Results. Subjective scores improved significantly in all groups, with no significative differences between groups (P<0,05).
The number of patients classified as C or D at the IKDC objective activity score was
higher in Group HT (2/20, 10%), than in Group BTB (1/20, 5%) and Group HT-E (0/20, 0%).
In term of failure-rate, there were no difference between the three groups (P<0,05).
Radiologic evaluation shoved more arthritic changes in Group-BT in the patello-femoral joint (PMJ).
Conclusions. All the three techniques showed satisfactory results at long term follow up with no differences in term of subjective scores. Finally, there was a statistically significant higher incidence of arthritic changes in PFJ as evaluated with x-ray in the BPTP group respect to HT and HT + ER groups (p<0.05).
Long-Term Clinical and Radiographic Results of ACL Reconstruction: Retrospective Comparison Between Three Techniques (Hamstrings Autograft, Hamstrings Autograft with xEtra-Articular Reconstruction, Bone Patellar Tendon Autograft)
P. Rota, E. Monaco, A. Carrozzo, G. Bruni, A. Rota, A. Ferretti
Original Article, 460-469
Keywords: Anterior cruciate ligament; extra articular reconstruction; hamstring tendon; knee joint; osteoarthritis; pivot-shift,
Table of Content: Vol. 10 (No.3) 2020 July/September
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