Similar results with quadrupled semitendinosus and semitendinosus-gracilis graft in anterior cruciate ligament reconstruction: A randomised controlled trial with 2-year follow-up.
rct · Level II
Where this comes from
- Record sourced from PubMed, PMID 41018256.
- Also identified by DOI 10.1002/jeo2.70399 and PMC identifier 12460705.
- Licence recorded as CC BY.
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Abstract
to compare quadrupled semitendinosus (STx4) with semitendinosus-gracilis graft in anterior cruciate ligament (ACL) reconstruction surgery. Parallel randomised controlled trial with two groups of treatment (<i>n</i> = 42) in primary ACL reconstruction surgery. Follow-up during 2 years after surgery with visits at 3, 6, 12 and 24 months. Primary outcome: quadriceps and hamstrings strength in newtons (N). Secondary outcomes: ACL re-rupture, additional surgeries, return to sport and patient-reported outcomes (PROMs): knee injury and osteoarthritis outcome score (KOOS), International Knee Documentation Committee (IKDC) and Tegner-Lysholm. There was 1/21 ACL re-rupture for STx4 and 2/21 for the control group (<i>p</i> = 0.9). One additional surgery for each group: ACL revision (control group) and meniscectomy (STx4). There were no other complications and no differences in PROMs between grafts, except for Tegner-Lysholm at 3 months, that favoured the STx4 group (76.0, confidence interval [CI]: 56.0-86.0 vs. 85.0, CI: 77.0-93.0), <i>p</i> = 0.04. The median surgery satisfaction was good in both groups STx4 (95%, interquartile range (IQR): 90%-98%) and ST-G (98%, IQR: 95%-100%) (<i>p</i> = 0.13). Return to sport was 90% (<i>n</i> = 19) for the STx4 group and 81% (<i>n</i> = 17) for the ST-G group (<i>p</i> = 0.37). Quadriceps strength recovered sooner (6 months) than hamstrings (24 months) in both groups. There were no statistically significant differences in strength between STx4 and ST-G at final follow-up (hamstrings in flexion [mean ± SD]: 173 ± 53 N vs. 166 ± 51 N, <i>p</i> = 0.7; hamstrings in extension: 204 ± 61 N vs. 199 ± 64 N, <i>p</i> = 0.8; quadriceps in flexion: 217 ± 42 N vs. 209 ± 47 N, <i>p</i> = 0.6; quadriceps in extension: 193 ± 51 N vs. 191 ± 46 N, <i>p</i> = 0.9). This study found no statistically significant differences at 2 years between a STx4 and a ST-G graft configuration for primary ACL reconstruction regarding strength, PROMs, return to sport, failure rates and complications; larger studies are required to confirm noninferiority. Clinical Trials number: NCT03433170. Level I.