Date of Award

Spring 2021

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Erin Wolf, BSN, MS, PA-C

Abstract

Introduction: ACL rupture is an extremely common injury among athletes of various sports. There are multiple different grafts that can be used in ACL reconstruction surgery. Two forms of graft that are most often considered in the case of ACL reconstruction are the hamstring tendon (HT) autograft and patellar tendon (PT) autograft. Many orthopedic providers have conflicting views regarding which of the two is the ideal graft. There are varying findings comparing the HT and PT, with many parameters to consider when predicting overall outcome. Oftentimes athletes who experience an ACL rupture are young and desire to return to sport while avoiding any detrimental impacts on their performance. It is relevant to evaluate each graft in terms of performance after return to sport considering how valuable this is to many young patients in need of ACL reconstruction.

Methods: A literature search was conducted with PubMed and Academic Search Ultimate in November of 2019. Seven articles were chosen for review based on their relevance, recency, population characteristics, and outcome measures.

Results: There were statistically significant differences found between the HT and PT autograft with regard to range of motion, stability/laxity, balance, and strength.

Discussion: While there were significant differences found between the two groups in most studies, not all parameters were studied by each article. There was a lack of consistency between articles in terms of outcome measure because multiple different outcomes were needed to assess overall sport performance.

Conclusion: The evidence available comparing HT and PT autograft continues to point towards patient and surgeon preference as the ultimate deciding factor. Young athletes who have suffered an ACL rupture should understand that both the HT and PT have benefits and risks, which are not substantial enough to completely rule out one or the other. While this paper found the HT autograft to result in higher balance, ROM, and stability, there are many more existing studies not analyzed in this paper which could provide more support for the PT autograft.

Additional Files

Poster Presentation Recording.mp4 (9497 kB)
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Comparison of sport performance outcomes in young athletes receiving hamstring autograft and patellar tendon autograft for anterior cruciate ligament (ACL) reconstruction surgery

Introduction: ACL rupture is an extremely common injury among athletes of various sports. There are multiple different grafts that can be used in ACL reconstruction surgery. Two forms of graft that are most often considered in the case of ACL reconstruction are the hamstring tendon (HT) autograft and patellar tendon (PT) autograft. Many orthopedic providers have conflicting views regarding which of the two is the ideal graft. There are varying findings comparing the HT and PT, with many parameters to consider when predicting overall outcome. Oftentimes athletes who experience an ACL rupture are young and desire to return to sport while avoiding any detrimental impacts on their performance. It is relevant to evaluate each graft in terms of performance after return to sport considering how valuable this is to many young patients in need of ACL reconstruction.

Methods: A literature search was conducted with PubMed and Academic Search Ultimate in November of 2019. Seven articles were chosen for review based on their relevance, recency, population characteristics, and outcome measures.

Results: There were statistically significant differences found between the HT and PT autograft with regard to range of motion, stability/laxity, balance, and strength.

Discussion: While there were significant differences found between the two groups in most studies, not all parameters were studied by each article. There was a lack of consistency between articles in terms of outcome measure because multiple different outcomes were needed to assess overall sport performance.

Conclusion: The evidence available comparing HT and PT autograft continues to point towards patient and surgeon preference as the ultimate deciding factor. Young athletes who have suffered an ACL rupture should understand that both the HT and PT have benefits and risks, which are not substantial enough to completely rule out one or the other. While this paper found the HT autograft to result in higher balance, ROM, and stability, there are many more existing studies not analyzed in this paper which could provide more support for the PT autograft.