A comparison between patellar tendon and doubled semitendinosus/gracilis tendon for anterior cruciate ligament reconstruction. A minimum five-year follow-up

The results of arthroscopic anterior cruciate ligament reconstruction performed by the same surgeon alternately with patellar tendon (PT) and doubled semitendinosus/gracilis tendon (DSTG) grafts in two groups of 30 patients With chronic isolated unilateral tears have been prospectively compared. There were not significant differences in terms of age, sex, injury-surgery interval and level of sport. At an average follow-up of 5.7 yrs (range 5.2-6.2) the patients were evaluated by clinical (IKDC form), arthrometric (KT-2000) and isokinetic (Cybex II) testing. Two significant differences were noted: giving way absent in the PT group, was 13% in the DSTG group (p = .03); recovery of hamstrings strength was lower in the DSTG group at both 60 degrees and 180 degrees/sec (p = .03 and p = .007 respectively). Return to sport, objective stability, ROM and patellofemoral symptoms were not significantly different. Anterior tibial translation compared with the contralateral knee (30 lbs) was more than 5 mm in 17% of the PT group versus 30% of the DSTG group (n.s.). We feel that the PT is the graft of choice for athletes with more serious joint laxity, since it gives better results in terms of stability and has less influence on the recovery of muscle strength. The semitendinosus and gracilis tendons, however, provide a sound alternative for patients with a lower functional demand, prior patellofemoral problems, and without associated ligament lesions and in revision surgery after employment of the PT.