A difference in rotational alignment of the tibio-femoral joint after anterior cruciate ligament reconstruction between the bone-patellar tendon-bone and semitendinosus-gracilis grafts

Abstract

BackgroundA question as to the effect of the graft choice on rotational kinematics after anterior cruciate ligament reconstruction remains unclear. The purpose of this study was to determine if there were any differences in rotational alignment of the knee after anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BTB) graft compared to that using semitendinosus-gracilis (STG) graft. MethodsTen patients with BTB graft and 10 patients with STG graft were assessed at 3 months after ACL reconstruction. We compared the 6 degrees-of-freedom alignment of the tibiofemoral joint in the fully extended position between knees reconstructed with BTB graft and STG graft using the uninvolved knee as a control. FindingsThe BTB graft group showed no difference in knee alignment between the ACL reconstructed knee and uninvolved knee, whereas the STG graft group showed greater external rotation in the ACL reconstructed knee than in the uninvolved knee (median values, 8.4° vs 5.8°; p = 0.022). InterpretationACL reconstruction with the STG graft leads to increased external tibial rotation. Our findings suggest that clinicians should make an effort to prevent increased external tibial rotation during the rehabilitation process in patients with STG graft.