Comparison of patellar versus hamstring tendon autografts in patients undergoing arthroscopic anterior cruciate ligament reconstruction: A 6?month follow?up of a randomized clinical trial

Alireza Sadeghpour, Adel Ebrahimpour, Bahamin Attar, Zahra Azizian


Background: Te purpose of this study was to compare the outcomes of anterior cruciate ligament (ACL) reconstruction using the patellar versus  hamstring tendon (HT) autograft. Materials and Methods: In this  randomized clinical trial, ffty patients undergoing arthroscopic ACL  reconstruction were randomized into two equal groups: Tose treated with  either autogenous patellar tendon grafts (PT group) or HT group grafts. All  patients were reviewed immediately after surgery, at 6 and 12 weeks after surgery, and then at 6 months using the International Knee  Documentation Committee evaluation form. Infection, severity of pain  (visual analog scale), duration of rehabilitation, and clinical and magnetic  resonance imaging (MRI) fndings were assessed at the 6?month follow?up. Positive pivot shift and Lachman test were considered clinical signs and  symptoms of treatment failure. In addition, the absence of the ACL or transverse ACL rather than the posterior oblique ligament is an MRI fnding that indicates treatment failure. Result: Comparing changes in pain and range of motion (ROM) in patients frst and 6 months after therapy show that pain had been relief signifcantly (P < 0.001) and ROM dramatically  changes (P < 0.001). Te average rehabilitation period in the PT group was 13.2 ± 2.08 weeks whereas in the HT group, it was 9.28 ± 2.26 weeks. A signifcant di?erence was seen between the two groups in terms of the  rehabilitation period (P < 0.001). No signifcant di?erence was found in the normal ROM between the groups (P = 0.32). When the pain severity was considered, a signifcant di?erence was found between the PT group and the HT group (P < 0.001). Te HT group patients had less knee pain than did the PT group patients. No signifcant di?erence in infection rates was seen between two groups (P = 0.66). Conclusion: Considering the better  outcomes of HT reconstructions for the two parameters of pain severity and rehabilitation period, we consider HTs to be the ideal graft choice for ACL reconstructions.


Anterior cruciate ligament, autogenous graft, hamstring tendons, patellar tendons

Full Text: