Is quadruple semitendinosus tendon strands autograft a better choice than hamstring autograft for anterior cruciate ligament reconstruction? A comparative study with a mean follow-up of 3 years.

Abstract

The purpose of this study was to compare the clinical outcomes of ST4 with those of STGs with a minimum follow-up of 3 years. The hypothesis was that functional outcomes of the ST4 technique are at least as good as those of the STG technique. Cohort study. Level of evidence, 3 METHODS: Eighty-seven consecutive patients underwent isolated ACL reconstruction, 50 with the ST4 and 37 with STG. At the femoral side for both groups, the system of the fixation of the graft used a cortical fixation support and at the tibial side the group STG used an interference screw and the ST4 group used a tape locked system fixed by an interference screw. Clinical results were compared: IKDC score, KT-1000 arthrometry, radiologic evaluation of the differential laxity, as well as the Tegner score and the KOOS score. Two patients had a rerupture (STG), one in the ST4 group. The analysis of the subjective clinical results showed no statistically significant difference between the 2 groups. Differential laximetry was 0.7 mm ± 0.4 (0 to 2 mm) for the ST4 group and 1.6 ± 0.5 mm (0 to 3 mm) for the STG group with a statistically significant difference in favor of the ST4 group (p < 0.05). Age, sex, and presence of meniscal lesions were the factors influencing the KOOS score. This study comparing the clinical and laximetric results at the minimum 3-year follow-up of 2 ACL reconstruction techniques (ST4 vs STG) confirms the working hypothesis with an overall better score for the ST4 group.