Medium-long Term Efficacy Analysis Of Arthroscopic Anterior Cruciate Ligament Reconstruction With Autograft Hamstring Tendon And Bone-patellar Tendon-bone

Objective:This study retrospectively analyzed the middle and long-term efficacy of the arthroscopic anterior cruciate ligament reconstruction with autograft hamstring tendons or patellar tendon, so as to provide evidence for treatment method choice of injury knee instability.Methods:This study retrospectively analyzed the patients with anterior cruciate ligament injury from August 1999 to October 2013 in Tianjin Medical University General Hospital. The 278 patients were individed into two groups, the ACL were reconstructed with autograft hamstring(Group A) or patellar tendon(Group B).Lachman test and anterior drawer test, IKDC and Lysholm scores were analyzed preoperative and 1 month, 3 months, 6 months, 1 year, 5 years, 10 years after the operation.The data was analyzed with SPSS.Results:In terms of the Lachman test and anterior drawer test, positive rate of Hamstrings group increased year by year, and was statistically significant(P <0.05),but BTBgroup was not statistically significant(P> 0.05).At the time of postoperative3 months, there was statistically significant difference of the Lysholm score and IKDC score between the two groups(P <0.05). The score of the Hamstring group was higher than the patellar tendon group. After a month, 6 months, 1 year, 5 years, 10 years, at hamstring and patellar tendon group group, There was no statistically significant between the Lysholm score and IKDC score of the two groups(P> 0.05).The Lysholm score and IKDC scores of the two groups gradually increased, and there were statistically significants differents in each group(P <0.05), except at the time of5 years and 10 years after the operation. In terms of patellar pain, after one month,three months, six months, 1 year, prepatellar pain on hamstring group was significantly lower than the BTB group, and the difference was statistically significant, but after 5 years, 10 years after, pain rate of two prepatellar was not significantly different. After 1 year revision rate was no significant differencebetween the two groups, after 1 year, 5-year failure rates in both groups were lower than 5%. After 5 years and after 10 years, the revision rate of hamstring group was significantly higher than BTP group, and the difference was statistically significant.In conclusion:Autograft hamstring or BTB both were positive and effective grafts for the ACL reconstruction.At the early-term after surgery, hamstring tendon was better than the patellar tendon, due to its less trauma, which indicated that hamstring tendon could provide earlier functional training. Autograft BTB ligament strength was better than hamstring tendon, and long-term effects was also better, but had a higher pain prepatellar.