Comparative Kinematic Analysis of Patellar vs. Hamstring Autografts in ACL Reconstruction on Side-Hop Test Performance

Abstract

Purpose: Anterior cruciate ligament injury is a prevalent lesion both in the athletic world as well as in the general population, rendering its' reconstruction a popular surgical procedure worldwide. This study aims to analyze the biomechanical differences in knees that underwent reconstruction with four-strand hamstring or bone-patellar tendon-bone autografts during side-hop test. Methods: This case-control study included 46 participants, 18 were healthy controls and 28 had anterior cruciate ligament tears and were subjected to reconstruction either with hamstring (n = 15) or patellar (n = 13) tendons. Theia Markerless system and Visual3D allowed us to obtain information on knee kinematics, namely time of contact to the ground, maximum varus and valgus and flexion during maximum valgus and varus. Additionally, Tegner Activity Scale enabled the evaluation of activity level variation post-surgery. The data analysis and comparison were performed by using ANOVA and Tukey. Results: Differences were found in terms of contact time with the ground between the autograft groups and the control group (p = 0.025, g = -1.13; p = 0.014, g = -1.09). However, no differences were shown between hamstring and patellar tendon autografts. None of the other variables studied showed statistically significant differences, however it was seen a slight tendency to greater valgus in autografts with patellar autografts and bigger varus on the knees reconstructed with hamstring tendons. Conclusions: In this study we demonstrated that no differences on side hop analysis were found between these techniques 12 months after surgery. The lack of differences between the intervention groups, and between these and the control group, may suggest that both autografts allow knee kinematics restoration resorting to neuromuscular and proprioceptive mechanisms that overcome the anatomical alterations.