Functional outcomes of bone tendon bone versus soft tissue arthroscopic anterior cruciate ligament reconstruction. A comparative study

OBJECTIVE: To compare functional outcomes of anterior cruciate ligament (ACL) reconstruction using 2 graft techniques and to determine factors affecting these outcomes.

METHODS: Thirty-four consecutive patients with ACL injuries surgically treated at King Abdulaziz University Hospital, Jeddah, Saudi Arabia between November 2003 and February 2011 were retrospectively assessed. Reconstruction was with bone-patellar tendon-bone autograft in 16 patients (BPTB group) and hamstring soft tissue autograft in 18 patients (ST group). Data were collected at an average of 3.5+/-1.75 years post-operatively, which included Western Ontario and McMaster Universities Arthritis Index (WOMAC) and International Knee Documentation Committee (IKDC) scores, and an 18 point questionnaire.

RESULTS: The final mean WOMAC score was 82 in the BPTB group, and 80 in the ST group. The mean IKDC score was 71 in the BPTB group, and 65 in the ST group (p>0.05). Twenty-one patients (61.8%) returned to their pre-injury level of activity after surgery (47.6% in BPTB group, and 52.4% in the ST group) and 27 patients (79.4%) returned to the same job (10 in BPTB group, and 17 in ST group [p=0.021]). No differences were noted between the 2 groups with regard to anterior knee pain, or patello-femoral symptoms (p>0.05).

CONCLUSION: Similar outcomes were noted with similar numbers returning to sports. Concerns of anterior knee pain and patello-femoral symptoms associated with BPTB grafts did not affect outcomes related to cultural and religious functions.