Bone-patellar Tendon-bone Autografts Versus Hamstring Autografts For Reconstruction Of Anterior Cruciate Ligament: A Meta-analysis

ObjectiveAnterior cruciate ligament rupture is the most common in knee ligament injury. To prevent secondary meniscus and the cartilage damage and resume their activity before hurt, reconstruction of anterior cruciate ligament is required. In the past 10 years, technique of anterior cruciate ligament reconstruction has been rapidly developed, but the choice of grafts is still controversial. Currently, more common autografts are bone-patellar tendon-bone, hamstring tendon, etc. Bone-patellar tendon-bone autograft is still gold standard of anterior cruciate ligament reconstruction for years. Compared to.hamstring antografts, bone-patellar tendon-bone autografts have more stable and more chance to restore activity function. Clinical findings, postoperative anterior knee symptoms in patients who used bone-patellar tendon-bone is twice than that using hamstring tendon. However, many randomized clinical study results contradict with this.Three Meta-analyses about anterior cruciate ligament reconstruction did not come to a definite conclusion. Many clinical surgeons only pay attention to one of them. The purpose is to compare bone-patellar tendon-bone autografts with hamstring autografts for reconstruction of the anterior cruciate ligament, and to provide reference for clinical doctor selecting grafts.MethodsWe performed a meta-analysis of all previously published trials from 1999 to 2009 comparing bone-patellar tendon-bone autografts with hamstring autografts for reconstruction of anterior cruciate ligament, reporting one or more outcome related to body examination and function of knee.Results15 trials met the inclusion criteria. Odds ratio of a positive pivot test was 1.39 (95%CI(0.82,2.36),P= 0.23), of a positive Lachman test 1.30(95%CI (0.90,1.88), P=0.17), of anterior knee pain 0.43 (95%CI (0.30,0.61), P< 0.0001) and of loss of extension (>5°) 0.44 (95%CI (0.24,0.79)P= 0.007).ConclusionMorbidity was lower for hamstring autografts than for patellar tendon autografts. Evidence that patellar tendon autografts offer better stability was weak.