Abstract des Autors

Arthroscopic anterior cruciate ligament (LCA) replacement was performed in 134 cases by autologous bone-patellar tendon-bone free graft (PAT) and in 59 cases by autologous semitendinosus-gracilis tendon distally shafted graft (STGR) between January 1989 and December 1993 in the Sports Surgical Department of National Institute of Sports Medicine. The aim of the study was to compare the operative results of the two different grafts. Eighty-five competitive athletes, 51 in PAT and 34 in STGR group (mean age 24.9 resp. 23.7 years) took part in the follow-up study during 31.8 (24-27) months in the average. There was no significant difference between preoperative and operative findings in the two groups. Rehabilitation was performed in both groups according to the same principles (6 weeks without weight bearing, use of external brace, coming back to competitive sport after 8 months). The follow-up was evaluated by means of IKDC "Knee Ligament Standard Evaluation Form". Stability values in PAT group were significantly better than those of STGR group (p<0.05). Stability measurements were made by KT-1000 arthrometer. The anterosagittal tibial movement test proved to be positive (i.e. above 5 mm) in 6 cases (12%) of PAT and in 7 cases (21%) of STGR group. Performing the passive movement test by maximal manual power a more than 5 mm difference was observed in 7 cases (14%) in PAT and in 9 cases (26%) in STGR group. An extension deficit of more than 10 degrees developed only in PAT group (12%). Patellofemoral crepitation was observed in 29% of the PAT and in 9% of the STGR group. Eighty-eight % of PAT, 82% of STGR group patients could go back to sporting activity. According to the investigation both grafts could be recommended for autologous LCA replacement, but in athletes, mainly in competitive athletes autologous bone-patellar tendon-bone free graft proved to be more advantageous. In certain cases (below 18 years of age, sedentary people, athletes with patellofemoral problems, "jumping athletes", reoperations) autologous semitendinosus-gracilis tendon graft has to be considered. Verf.-Referat