Prospective and Randomized Clinical Evaluation of Hamstring Versus Patellar Tendon Autograft for Anterior Cruciate Ligament Reconstruction in Soccer Players

前瞻性和随机临床评估腘绳肌与髌腱自体移植在足球运动员前交叉韧带重建中的应用

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作者:Luiz Gabriel Betoni Guglielmetti, Victor Eduardo Roman Salas, Pedro Baches Jorge, Fabrício Roberto Severino, Aires Duarte, Victor Marques de Oliveira, Ricardo de Paula Leite Cury

Background

Anterior cruciate ligament (ACL) reconstruction is usually performed with autologous bone-patellar tendon-bone (PT) or hamstring tendon (HT) graft. There has been only 1 randomized clinical trial examining ACL reconstruction with these grafts specifically in soccer players, and more studies comparing these graft types within a homogenous cohort such as soccer athletes may better highlight differences in outcomes.

Conclusion

There were no differences between soccer players who underwent different types of ACL reconstruction with the exception of anterior knee pain, which was more frequent in players who underwent reconstruction with PT graft.Registration: NCT02642692 (ClinicalTrials.gov).

Methods

A total of 62 professional or semiprofessional soccer players (mean age, 25.1 years) with ACL injury were randomized to undergo reconstruction with PT or HT autograft by a single orthopaedic surgeon (n = 31 in each group). Outcome measures were recorded preoperatively and at 2 years postoperatively. The primary outcome was the modified Cincinnati Knee Rating System, and secondary outcomes were the objective and subjective International Knee Documentation Committee scores, Lachman test, pivot-shift test, anterior drawer test, and Lysholm score. The following variables were also evaluated postoperatively: return to soccer, level at return, graft rerupture, postoperative complications, anterior knee pain, patellar tendinitis, difficulty sprinting, and loss of kicking power.

Purpose

To compare the

Results

The PT and HT groups were homogenous in terms of age, sex distribution, injured side, and time from injury to surgery, and there was no difference between them on any preoperative outcome score. At 2 years postoperatively, there were no differences between the groups on any outcome score; however, there were significantly fewer patients with anterior knee pain in the HT group compared with the PT group (7 [22.6%] vs 15 [48.4%], respectively; P = .03). Two patients from each group (2/31; 6.5%) sustained rerupture.

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