Abstracts: A 10-year comparison of anterior cruciate ligament reconstructions with hamstring tendon and patellar tendon autograft: a controlled, prospective trial

There are no controlled, prospective studies comparing the 10-year outcomes of anterior cruciate ligament (ACL) reconstruction using patellar tendon (PT) and four-strand hamstring tendon (HT) autografts. Comparable results are possible with HT and PT autografts. Cohort study; Level of evidence, 2. One hundred and eighty ACL-deficient knees that met inclusion criteria underwent ACL reconstruction (90 HT autograft, 90 PT autograft) by one surgeon and were treated with an accelerated rehabilitation program. All knees were observed in a prospective fashion with subjective, objective, and radiographic evaluation at 2-, 5-, 7-, and 10-year intervals. At 10 years, there were no differences in graft rupture rates (7/90 PT vs 12/90 HT, P = 0.24). There were 20 contralateral ACL ruptures in the PT group, compared with nine in the HT group (P = 0.02). In all patients, graft rupture was associated with instrumented laxity > 2 mm at 2 years (P = 0.001). Normal or near-normal function of the knee was reported in 97% of patients in both groups. In the PT group, harvest-site symptoms (P = 0.001) and kneeling pain (P = 0.01) were more common than in the HT group. More patients reported pain with strenuous activities in PT knees than in HT knees (P = 0.05). Radiographic osteoarthritis was more common in PT knees than the HT-reconstructed knees (P = 0.04). The difference, however, was composed of patients with mild osteoarthritis. Other predictors of radiographic osteoarthritis were