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A Comparative Study on the Postoperative Outcomes of Anterior Cruciate Ligament Reconstruction Using Patellar Bone-Tendon Autografts and Bone-Patellar Tendon-Bone Autografts.

Authors
 Sung-Jae Kim  ;  Ji-Young Yoon  ;  Seong-Min Kim  ;  Seungjoo Ha  ;  Sung-Hwan Kim  ;  Inje Cho 
Citation
 ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, Vol.32(6) : 1072-1079, 2016 
Journal Title
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY
ISSN
 0749-8063 
Issue Date
2016
MeSH
Adolescent ; Adult ; Anterior Cruciate Ligament Reconstruction/methods* ; Autografts ; Bone-Patellar Tendon-Bone Grafting/methods* ; Female ; Follow-Up Studies ; Humans ; Joint Instability/surgery ; Knee Joint/surgery ; Male ; Middle Aged ; Pain Measurement ; Retrospective Studies ; Young Adult
Abstract
PURPOSE: To evaluate and compare the clinical outcomes of anterior cruciate ligament (ACL) reconstruction using a bone-patellar tendon-bone (BPTB) autograft and a patellar bone-tendon (PBT) autograft.
METHODS: Seventy-nine patients who underwent ACL reconstruction using either a BPTB autograft or a PBT autograft were retrospectively evaluated. The minimum follow-up period was 24 months after surgery. A graft selection was determined by the patellar tendon length as measured on preoperative magnetic resonance imaging. If the patellar tendon length was longer than or equal to 45 mm, a PBT graft attached with the EndoPearl device was used. Fifty-one patients used BPTB autografts (group B) and 28 patients used PBT autografts (group P). The Lachman test, pivot-shift test, and anterior translation tested with a KT2000 arthrometer were assessed. Functional outcomes were assessed with the use of the Lysholm score, International Knee Documentation Committee subjective score, and objective grade. Anterior knee pain including kneeling pain was assessed with the use of the Shelbourne and Trumper questionnaire.
RESULTS: There was no statistically significant difference between the 2 groups in the postoperative values of degree of anterior translation (P = .76), Lysholm score (P = .62), International Knee Documentation Committee subjective score (P = .91), and objective grade (P = .91). However, anterior knee pain assessed with the use of the Shelbourne and Trumper questionnaire (group B = 90 [range, 65 to 100], group P = 95 [range, 59 to 100], P = .02) and number of patients having kneeling pain (group B = 41%, group P = 18%, P = .04) differed significantly between the 2 groups.
CONCLUSIONS: ACL reconstruction using a PBT autograft provided reliable knee stability comparable to a BPTB autograft but with less kneeling pain. For patients who have a long patellar tendon that may cause graft-tunnel mismatch, a PBT can be an effective alternative graft option for arthroscopic ACL reconstruction.
LEVEL OF EVIDENCE: Level III, retrospective comparative study.
Full Text
http://www.sciencedirect.com/science/article/pii/S0749806315008877
DOI
10.1016/j.arthro.2015.10.023
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Hwan(김성환) ORCID logo https://orcid.org/0000-0001-5743-6241
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146977
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