Sports Injuries & Arthroscopy Functional Outcomes Following ACL Reconstruction Using Hamstring Vs Patellar Tendon Graft

Background: Anterior cruciate ligament (ACL) injury is a common cause of knee instability in young, active individuals. Arthroscopic ACL reconstruction is the treatment of choice for symptomatic patients, with hamstring tendon and bone–patellar tendon–bone (BPTB) autografts being the most commonly used grafts. However, the optimal graft choice remains controversial.

Aim; To compare the functional outcomes following arthroscopic ACL reconstruction using hamstring tendon autograft versus bone–patellar tendon–bone autograft.

Materials and Methods: This prospective comparative study was conducted in the Department of Orthopaedics, Rajshree Medical College and Research Centre, Bareilly, Uttar Pradesh, over a period of one year. Thirty patients with clinically and radiologically confirmed ACL injury were included and divided into two groups: Group A (hamstring tendon graft, n=15) and Group B (BPTB graft, n=15). All patients underwent arthroscopic single-bundle ACL reconstruction followed by a standardised rehabilitation protocol. Functional outcomes were assessed using the Lysholm Knee Scoring Scale, International Knee Documentation Committee (IKDC) score, and clinical stability tests at regular follow-up intervals up to one year.

Results; Both groups showed significant improvement in functional outcomes postoperatively. The mean Lysholm score improved from 58.4 ± 6.2 to 91.2 ± 4.1 in Group A and from 57.9 ± 5.8 to 92.5 ± 3.8 in Group B. The mean IKDC score at final follow-up was 87.4 ± 5.6 in Group A and 88.9 ± 5.2 in Group B. No statistically significant difference was observed between the two groups (p > 0.05). Anterior knee pain was more commonly reported in the patellar tendon graft group.

Conclusion; Both hamstring and patellar tendon autografts provide excellent and comparable functional outcomes following ACL reconstruction. However, hamstring tendon grafts are associated with lower donor site morbidity, making them a preferable option in patients requiring frequent kneeling or squatting.