ABSTRACT
The patellar tendon [PT] and the semitendinosus and gracilis [STG] currently are the most common types of grafts used for anterior cruciate [ACL] reconstruction. The aim of this work is to compare the results of reconstruction using the two graft types. Between April 2000,and March 2003, fifty six cases with ACL injury were diagnosed and treated in the arthroscopy and sport injuries unit in Assiut University hospital using Quardrupled semitendinosus and gracilis tendon [STG]. All patients were men with average age 28.4 years: ranged 18-42 years''. Out of these 56 cases, the results of 11 case were deducted because of loss of follow up in 6 cases and due to combined posterolateral corner instability in the other 5 cases. The follow up for this group ranged from 19 months to 35 months [average 23.3 months]. The remaining 45 cases in this group were compared to a group of the same number [45], operated in the same unit between March 1997 and October 2000 but using the patellar tendon autograft arthroscopically with average follow up 24 months [range 9-42 months], and they were all men except one . The rehabilitation program was standard and accelerated in both groups. Both groups were evaluated using the Lysholm Knee score and the International Knee Documentation Committee [IKDC] scores. The Lysholm evaluation showed excellent or good result in 89% of PT group and in 91.2% of the STG group with no statistically significant difference. The IKDC evaluation showed normal or nearly normal results in 89.3% of PT group and in 95.7% of the STG group. No difference was found between the two groups concerning the activity level and return to moderate or strenuous activity. Patello- Femoral crepitus, anterior knee pain and harvest site tenderness were more among the PT group. The extension loss and thigh atrophy were also more frequent in the PT group but the difference was not statistically significant [P-value]. Radiological enlargement of the bone tunnels was more prominent with the STG group although not affecting the final IKDC evaluation and has no clinical impact on the objective or subjective stability. In ACL reconstruction both the autogenous PT and STG grafts provide biomechanically excellent graft material but the STG with recent improvement in the fixation technique has several advantages over the PT graft