Comparison of Semitendinosus and Gracilis Tendon Versus Patellar Tendon Autografts .
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OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(11):298 Am J Sports Med; 2011; 39(10): 2161-2169Exclusive Author Interview
Dr. Sajovic comparing ACL hamstring and patellar tendon autografts
64 patients scheduled to undergo reconstruction for anterior cruciate ligament (ACL) ruptures were randomized to receive either hamstring tendon autograft or patellar tendon autograft. The results from 11 year follow-up indicated that there were no significant differences between the two groups in regards to functional or pain outcomes.It was also found that there were no significant differences in rate of graft failures between the two groups. However, the patellar tendon autograft group had a higher prevalence of osteoarthritis at 11 years.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sí = 1
Incierto = 0,5
No relevante = 0
No = 0
La evaluación de los criterios de información evalúa la transparencia con la que los autores informan de las características metodológicas y del ensayo dentro de la publicación. La evaluación se divide en cinco categorías que se presentan a continuación.
3/4
Randomization
3/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
El Índice de Fragilidad es una herramienta que ayuda en la interpretación de hallazgos significativos, proporcionando una medida de fuerza para un resultado. El Índice de Fragilidad representa el número de eventos consecutivos que es necesario añadir a un resultado dicotómico para que el hallazgo deje de ser significativo. Un número pequeño representa un hallazgo más débil y un número grande un hallazgo más fuerte.
¿Por qué se necesitaba ahora este estudio?
ACL injuries are common sports injuries, often in the younger population. The return to sports, long life, and prevention of secondary osteoarthritis are of primary importance. The choice of graft is an important decision for both the patient and the surgeon. Controversies still exist about graft selection for primary anterior cruciate ligament reconstruction. This study evaluates the long 14-year outcomes with two most common autografts (hamstring tendon autograft or patellar tendon autograft) used in ACL repair.
¿Cuál era la pregunta principal de la investigación?
Does patellar tendon autograft lead to similar functional and pain outcomes in comparison to hamstring tendon autograft in patients with ACL ruptures at 11 year follow-up?
- preoperative versus postoperative Lysholm knee scores showed a significant improvement in both groups (p<0.001)
- a greater number of patients reported anterior knee pain during strenuous activities or in kneeling-squatting position in the patellar tendon autograft group in comparison to the hamstring tendon autograft group (p=0.255)
- positive pivot-shift test (1 ) was significantly more frequent in the PT group (p=0.036)
- no significant differences in Short Form-36 or KT-1000 arthrometer laxity testing scores were observed between the two groups (p>0.05)
¿Qué es lo que más debo recordar?
Both interventions provided similar improvements in outcomes; however, it was found that the rate of osteoarthritis was significantly higher in the patellar tendon autograft group.
¿Cómo afectará esto al cuidado de mis pacientes?
Similar long-term results could be obtained by using either hamstring tendon or patellar tendon autografts in patients undergoing ACL reconstruction.
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