Clinical Outcomes after Arthroscopic ACL Reconstruction using Bone-Patellar Tendon-Bone Allografts, Anterior Tibialis Tendon Allografts, and Hamstring Tendon Autografts

ABSTRACT

PURPOSE: To use physical and quantitative tests and second look arthroscopy to compare knee joint stability, graft remodeling, and healing after arthroscopic anterior cruciate ligament (ACL) reconstruction in patients receiving bone-patellar tendon-bone (BPTB) allografts, tibialis anterior tendon (TA) allografts, and hamstring (HA) autografts. MATERIALS AND METHODS: We analyzed 338 patients who underwent ACL reconstruction between March 2000 and February 2006 and who were followed up for at least 1 year. There were 60 BPTB allografts, 153 TA allografts, and 125 HA autografts. We compared the range of motion (ROM), Lachman test, pivot shift test, KT-1000 arthrometer test, and International Knee Documentation Committee (IKDC) knee examination form among the three groups, as well as the laxity and synovial coverage of the grafts as determined by second look arthroscopy. RESULTS: There was no significant difference among the three groups with regard to preoperative and postoperative clinical and physical findings. Synovial coverage of greater than 50% was found in 60% of patients in the BPTB allograft group, in 69.2% of patients in the TA allograft group, and in 100% of patients in the HA autograft group. The HA autograft group had a higher incidence of synovial coverage greater than 50% (p=0.017, 0.025). Regarding IKDC grade, Grade A or B was found among 93.7% of the cases with synovial coverage greater than 50% and among 72.2% of the cases with synovial coverage less than 50%. There was a significant correlation between the extent of synovial coverage and the IKDC grade (p=0.015). CONCLUSION: The HA autograft group had superior synovial coverage over the other two groups on second look arthroscopy, and there was a significant correlation between the extent of synovial coverage and the IKDC grade.