Abstract

SILVA, Teresa; VIRGOLINO, Manuel; PESSOA, Pedro  and  RIBEIRO, Carlos. Ligamentoplastia do ligamento cruzado anterior Do osso-tendão-osso para os isquiotibiais: melhorámos?. Rev. Port. Ortop. Traum. [online]. 2013, vol.21, n.1, pp.27-36. ISSN 1646-2122.

The graft choice for reconstruction of the ACL is still a matter of debate. Over the last years hamstring graft has been favored over the patellar tendon graft. The objective of this study was to determine whether the type of graft affects the clinical, functional and radiographic outcome of anterior cruciate ligament reconstruction. We also intended to demonstrate which patient and injury factors affected the outcomes. In this retrospective study we compared 17 patients submitted to ACL reconstruction using hamstringautograft with 31 patients submitted to ACL reconstruction using patellar tendon autograft, with a follow-up of 2.18 years. We compared patient, injury, surgical, clinical, functional and radiological factors as well as global patient satisfaction. IKDC and Tegner-Lysholm scores were applied. Both groups obtained good to excellent functional scores with no statistic difference amongst them. Tallerpatients obtained better functional scores, independently of any other factor (IKDC p<0,02, TL p<0,01). We found no difference between the two groups for the presence of clinical instability (p=0,42) but we could verify that female patients have more risk of having clinical signs of instability (p=0.01). We did not find any difference between groups for sports activity, competition or leisure kind. (p=0,59 e p=1). We did not find any difference between groups for the presence of radiographic evidence of osteoarthritis but an association was found between the presence of osteoarthritis and the time between lesion and surgery (p=0.014). We concluded that the graft used for reconstruction of the ACL did not affect the outcomes for this group of patients. We identified a direct relation between the good to excellent results and the factors male sex, high height and a diminished time from injury to surgery.

Keywords : Anterior cruciate ligament; bone-tendon-bone; hamstring; height; female; osteoarthritis.

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