Abstract
Objective To compare clinical outcomes of patellar tendon and 4-strand hamstring au- tografts in single-bundle endoscopic reconstruction of anterior cruciate ligament （ACL） . Methods The digital databases （PubMed, Embase, Cochrane Central Register of Controlled Trials, CBM）were searched for randomized controlled trials （RCTs） comparing patellar tendon with hamstring autografls for reconstruction of ACL. In addition, the reference lists from related original studies and review articles were hand-searched. The Coehrane Collaboration＇ s tool for assessing risk of bias and Cochrane collaboration＇s RevMan 5.0 software were used for assessing trial methodological quality and data analyses. Results Fourteen RCTs were included. There were 1232 participants who met inclusion criteria in all studies. Meta-analyses showed that no statistically significant differences were found in graft failure rate after single-bundle reconstruction of the ACL at mean follow-ups of 2 to 3 years （ RR = 0.69, 95% CI O. 34 to 1.38, P = 0. 29, of 5 years （ RR = 0. 37, 95% C]0.09 to 1,55, P=0. 18）, of 10 years （P=0.94） or when 3 subgroups combined （RR=0.71, 95% CI O. 39 to 1.31, P =0.28） . The difference in ~〉 5~ extensor deficit was not statistically significant between the 2 groups （ RR = 1.63, 95% CI O. 85 to 3.16, P = 0. 14）. Anterior knee pain and kneeling pain or discomfort showed significantly differences between the 2 groups at a mean follow-up of 2 years （ P 〈 0. 05）, but did not at follow-ups of 5 years and 10 years （ P 〉 0. 05）. Conclusions In single-bundle endoscopic ACL reconstruction, patellar tendon and 4-strand hamstring autografts have similar rates of graft failure and knee motion deficits. The patellar tendon autograft may have higher rates of anterior knee pain and kneeling pain or discomfort at an early stage after operation than the 4-strand hamstring autograft, but there may be no such differences on a long-term basis. Key words: Patella ligament; Anterior erueiate ligament; Meta-analysis; Hamstring
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