Anterior Cruciate Ligament Reconstruction A Prospective Randomized Study of Three Surgical Methods

TLDR: There appears to be no benefit to combining an intraarticular anterior cruciate ligament reconstruction with an extraarticular procedure; however, the patellar tendon autograft may provide better objective stability in the long term.

Abstract: A prospective randomized study was performed to determine the differences in results between three methods of anterior cruciate ligament reconstruction: autogenous bone-patellar tendon-bone graft (group 1), semitendinosus and gracilis tendon graft reconstruction combined with an extraarticular procedure (group 2), and semitendinosus and gracilis tendon graft reconstruction alone (group 3). Preoperatively, there were no significant differences between groups. At a mean of 35.4±11.6 months postoperatively, 102 patients returned for evaluation. International Knee Documentation Committee knee evaluation revealed no significant differences in symptoms, function, return to pre-injury activity, harvest site abnormalities, or limitation of motion between groups 1 and 3. Patients in group 2 had a higher incidence of patellofemoral crepitation and loss of motion than did patients in group 3. The mean manual maximum KT-1000 arthrometer side-to-side difference was 2.1±2.0 mm in group 1, which was statistically signif...