Anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft is associated with higher and earlier return to sports as compared to hamstring tendon graft.

Abstract

To study the effect of age, duration of injury, type of graft and concomitant knee injuries on return to sports after anterior cruciate ligament (ACL) reconstruction. One-hundred and sixteen athletes underwent ACL reconstruction using either bone-patellar tendon-bone graft (BPTB; n = 58) or semitendinosus-gracilis graft (n = 58), depending upon their random number sequences. Five variables were analyzed in terms of their effect on return to sports-age, type of graft, time interval between injury and surgery, chondral damage and meniscal tears. Fifty-three out of 73 (72.6%) athletes aged between 16 and 25years and 21/43 (49%) athletes aged between 25 and 40years returned to sports (p = 0.02). The mean time to return to sports was 9.7 ± 2.1months and 10.8 ± 1.7months in athletes aged < 25years and 25-40years, respectively (p = 0.04). ACL reconstruction with BPTB graft (43/58) was associated with higher rate of return to sports as compared to hamstring tendon graft (31/58; p = 0.02). The mean duration of return to sports with BPTB and STGPI graft was 9.7 ± 2.0months and 10.7 ± 2.0months, respectively (p = 0.02). 29/36 (80.5%) patients operated between 2 and 6months, 18/29 (62%) operated in < 2months, and 27/51 (53%) operated after 6months of injury had returned to sports (p = 0.03). Athletes who were operated within 2months of the injury were the earliest to return to sports (9.4 ± 2.1months), followed by those operated within 2-6months (9.9 ± 1.9months) and lastly by the ones operated after 6months of the injury (10.9 ± 2.1months; p = 0.04). The rate of return to sports was observed to be higher in athletes younger than 25years as compared to older athletes (> 25years). ACL reconstruction with BPTB graft was associated with higher and earlier returns to sports as compared to hamstring graft. The rate of return to sports was highest if surgery was performed between 2 and 6months after the injury. III.