scholarly journals Change in Collagen Fibril Diameter Distribution of Bovine Anterior Cruciate Ligament upon Injury Can Be Mimicked in a Nanostructured Scaffold

Molecules ◽  
2021 ◽  
Vol 26 (5) ◽  
pp. 1204
Author(s):  
Zhuldyz Beisbayeva ◽  
Ainur Zhanbassynova ◽  
Gulzada Kulzhanova ◽  
Fariza Mukasheva ◽  
Cevat Erisken
Keyword(s):  
Anterior Cruciate Ligament ◽  
Collagen Fibril ◽  
Cruciate Ligament ◽  
Host Cells ◽  
Diameter Distribution ◽  
Subsequent Decrease ◽  
Significant Difference ◽  
Mean Diameter ◽  
Anterior Cruciate ◽  
Fibril Diameter

More than 200,000 people are suffering from Anterior Cruciate Ligament (ACL) related injuries each year in the US. There is an unmet clinical demand for improving biological attachment between grafts and the host tissue in addition to providing mechanical support. For biological graft integration, it is important to provide a physiologically feasible environment for the host cells to enable them to perform their duties. However, behavior of cells during ACL healing and the mechanism of ACL healing is not fully understood partly due to the absence of appropriate environment to test cell behavior both in vitro and in vivo. This study aims at (i) investigating the change in fibril diameter of bovine ACL tissue upon injury and (ii) fabricating nanofiber-based scaffolds to represent the morphology and structure of healthy and injured ACL tissues. We hypothesized that distribution and mean diameter of ACL fibrils will be altered upon injury. Findings revealed that the collagen fibril diameter distribution of bovine ACL changed from bimodal to unimodal upon injury with subsequent decrease in mean diameter. Polycaprolactone (PCL) scaffold fiber diameter distribution exhibited similar bimodal and unimodal distribution behavior to qualitatively represent the cases of healthy and injured ACL, respectively. The native ACL tissue demonstrated comparable modulus values only with the aligned bimodal PCL scaffolds. There was significant difference between mechanical properties of aligned bimodal and unaligned unimodal PCL scaffolds. We believe that the results obtained from measurements of diameter of collagen fibrils of native bovine ACL tissue can serve as a benchmark for scaffold design.

scholarly journals Clinical Outcomes of Arthroscopic Notchplasty and Partial Resection for Mucoid Degeneration of the Anterior Cruciate Ligament

2021 ◽  
Vol 10 (2) ◽  
pp. 315
Author(s):  
Joong Won Lee ◽  
Jung Tae Ahn ◽  
Hyun Gon Gwak ◽  
Sang Hak Lee
Keyword(s):  
Anterior Cruciate Ligament ◽  
Clinical Outcomes ◽  
Cruciate Ligament ◽  
Arthroscopic Surgery ◽  
Partial Resection ◽  
Knee Score ◽  
Mucoid Degeneration ◽  
Duration Of Symptoms ◽  
Significant Difference ◽  
Anterior Cruciate

Background: Mucoid degeneration of the anterior cruciate ligament (MD-ACL) is a chronic degenerative process involving a hypertrophied ACL, which may lead to notch impingement syndrome. As a treatment method, there is consensus regarding arthroscopic resection for MD-ACL resulting in good clinical outcomes; however, additional notchplasty remains controversial. The purpose of this study was to investigate clinical outcomes after arthroscopic partial resection of the ACL and additional notchplasty performed to minimize volume reduction of the ACL. Study Design: Level IIIb retrospective cohort study. Methods: Of 1810 individuals who underwent knee arthroscopic surgery performed by the same surgeon between July 2011 and October 2020, 52 were included, while 10 were excluded due to a follow-up period of <1 year. Clinical data including pain location, terminal flexion or extension pain, range of motion (ROM), Lysholm knee score, and Hospital for Special Surgery (HSS) knee score were assessed pre- and postoperatively. Additionally, according to the resected volume of the ACL, patients were classified into two groups: <25% (Group 1), and 25–50% (Group 2). Clinical outcomes were compared between the two groups. Results: There were 17 (40.5%) men and 25 (59.5%) women with a mean age of 53.9 years (range, 16–81 years) at the time of surgery. The mean duration of symptoms before surgery was 14.4 months (range, 3–66 months). Arthroscopic partial resection of the MD-ACL was performed in all patients, and concomitant notchplasty was performed in 36 (81.8%). All clinical scores improved postoperatively, and were statistically significant (p < 0.01). However, there was no significant difference in clinical outcomes between groups 1 and 2 classified according to the resected ACL volume. Recurrence of MD-ACL was recorded in only one patient, 11 months after arthroscopic treatment. No patients underwent ACL reconstruction because of symptoms of anterior instability. Conclusion: Arthroscopic partial resection of the ACL and concomitant notchplasty yielded satisfactory outcomes for the treatment of MD-ACL. Notchplasty may be an alternative procedure to avoid total ACL resection and postoperative instability.

scholarly journals Morphometric characteristics of the patellar tendon

2016 ◽  
Vol 69 (suppl. 1) ◽  
pp. 53-58
Author(s):  
Milodrag Vranjes ◽  
Ivan Vukasinovic ◽  
Mirko Obradovic ◽  
Mile Bjelobrk ◽  
Zlatko Budinski ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Body Weight ◽  
Body Mass ◽  
Patellar Tendon ◽  
Cruciate Ligament ◽  
The Body ◽  
Professional Athletes ◽  
Morphometric Characteristics ◽  
Significant Difference ◽  
Anterior Cruciate

Introduction. The most common injuries of the knee joint are injuries of the anterior cruciate ligament. The golden standard in reconstruction of this ligament is graft bone - patellar tendon - bone. Knowing the morphometric characteristics of these ligaments is crucial for anterior cruciate ligament reconstruction. This study was aimed at determining morphometric characteristics of the patellar tendon in vivo, measured intraoperatively, and at defining the correlation between the obtained values and body weight, height, gender and sport activity among different groups of athletes. Material and Methods. This study included 184 patients suffering from anterior cruciate ligament injuries who were admitted to the Clinical Center of Vojvodina, Department of Orthopedics and Traumatology. Results. The patellar tendon width ranged from 28 mm to 43 mm, averaging at 32.02 mm. The length of the patellar tendon ranged from 35 mm to 62 mm, averaging at 46.34 mm. The thickness of the patellar tendon ranged from 3 mm to 6 mm, averaging at 3.78 mm. The measured results were positively and statistically relevant with the body mass, height and body mass index. Discussion and Conclusion. The patellar tendon was thicker, longer and wider in persons with higher values of body weight and height. Men have statistically longer, thicker and wider patellar tendon than women. There was no statistically significant difference between morphometric characteristics of the patellar tendon among professional athletes and recreational athletes, neither was there one in the obtained geometric data of the patellar tendon among tested groups of professional athletes.

scholarly journals Performance of the PROMIS in Patients After Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 6 (5) ◽  
pp. 232596711877450 ◽  
Author(s):  
Elizabeth J. Scott ◽  
Robert Westermann ◽  
Nathalie A. Glass ◽  
Carolyn Hettrich ◽  
Brian R. Wolf ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Physical Function ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Sf 36 ◽  
Significant Difference ◽  
Patient Reported ◽  
Floor Effects ◽  
Anterior Cruciate ◽  
Pro Instruments

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) is designed to advance patient-reported outcome (PRO) instruments by utilizing question banks for major health domains. Purpose: To compare the responsiveness and construct validity of the PROMIS physical function computer adaptive test (PF CAT) with current PRO instruments for patients before and up to 2 years after anterior cruciate ligament (ACL) reconstruction. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Initially, 157 patients completed the PROMIS PF CAT, Short Form–36 Health Survey (SF-36 physical function [PF] and general health [GH]), Marx Activity Rating Scale (MARS), Knee injury and Osteoarthritis Outcome Score (KOOS activities of daily living [ADL], sport, and quality of life [QOL]), and EuroQol–5 dimensions questionnaire (EQ-5D) at 6 weeks, 6 months, and 2 years after ACL reconstruction. Correlations between instruments, ceiling and floor effects, effect sizes (Cohen d), and standardized response means to describe responsiveness were evaluated. Subgroup analyses compared participants with and without additional arthroscopic procedures using linear mixed models. Results: At baseline, 6 weeks, and 6 months, the PROMIS PF CAT showed excellent or excellent-good correlations with the SF-36 PF ( r = 0.75-0.80, P < .01), KOOS-ADL ( r = 0.63-0.70, P < .01), and KOOS-sport ( r = 0.32-0.69, P < .01); excellent-good correlation with the EQ-5D ( r = 0.60-0.71, P < .01); and good correlation with the KOOS-QOL ( r = 0.52-0.58, P < .01). As expected, there were poor correlations with the MARS ( r = 0.00-0.24, P < .01) and SF-36 GH ( r = 0.16-0.34, P < .01 ). At 2 years, the PROMIS PF CAT showed good to excellent correlations with all PRO instruments ( r = 0.42-0.72, P < .01), including the MARS ( r = 0.42, P < .01), indicating frequent return to preinjury function. The PROMIS PF CAT had the fewest ceiling or floor effects of all instruments tested, and patients answered, on average, 4 questions. There was no significant difference in baseline physical function scores between subgroups; at follow-up, all groups showed improvements in scores that were not statistically different. Conclusion: The PROMIS PF CAT is a valid tool to assess outcomes after ACL reconstruction up to 2 years after surgery, demonstrating the highest responsiveness to change with the fewest ceiling and floor effects and a low time burden among all instruments tested. The PROMIS PF CAT is a beneficial alternative for assessing physical function in adults before and after ACL reconstruction.

scholarly journals Is Remnant Preservation in Anterior Cruciate Ligament Reconstruction Superior to the Standard Technique? A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Han Wang ◽  
Ziming Liu ◽  
Yuwan Li ◽  
Yihang Peng ◽  
Wei Xu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Cruciate Ligament Reconstruction ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Postoperative Knee

Purpose. This is a systematic review and meta-analysis of current evidence that aims at comparing the clinical outcomes of remnant-preserving anterior cruciate ligament reconstruction (ACLR) and standard ACLR. Methods. A systematic review of randomized controlled studies and cohort studies comparing remnant-preserving ACLR with standard ACLR with a minimum level of evidence of II was performed. Studies were included by strict inclusion and exclusion criteria. Extracted data were summarized as preoperative conditions, postoperative clinical outcomes, and postoperative complications. When feasible, meta-analysis was performed with RevMan5.3 software. Study methodological quality was evaluated with the modified Coleman methodology score (CMS). Results. Eleven studies (n = 466 remnant-preserving and n = 536 standard) met the inclusion criteria. The mean modified CMS for all included studies was 85.8 (range: 77–92 on a 100-point scale). In total, 466 patients underwent remnant-preserving ACLR by 3 different procedures: standard ACLR plus tibial remnant tensioning (n = 283), selective-bundle augmentation (n = 49), and standard ACLR plus tibial remnant sparing (n = 134). Remnant-preserving ACLR provided a superior outcome of postoperative knee anterior stability (WMD = −0.42, 95% CI, −0.66, −0.17; P<0.01) and Lysholm score (WMD = 2.01, 95% CI, 0.53 to 3.50; P<0.01). There was no significant difference between the two groups with respect to second-look arthroscopy (OR = 1.38, 95% CI, 0.53, 3.62; P=0.51), complications (OR = 1.24 95% CI, 0.76, 2.02; P=0.39), International Knee Documentation Committee (IKDC) subject scores, IKDC grades, Lachman test, and pivot-shift test. Summary/conclusion. Remnant-preserving ACLR promotes similar graft synovial coverage and revascularization to standard ACLR. Equivalent or superior postoperative knee stability and clinical scores were observed for remnant-preserving ACLR compared with standard ACLR. No significant difference in the total complication rate between the groups was evident.

scholarly journals Anterolateral Ligament Reconstruction Protects the Repaired Medial Meniscus: A Comparative Study of 383 Anterior Cruciate Ligament Reconstructions From the SANTI Study Group With a Minimum Follow-up of 2 Years

2018 ◽  
Vol 46 (8) ◽  
pp. 1819-1826 ◽  
Author(s):  
Bertrand Sonnery-Cottet ◽  
Adnan Saithna ◽  
William G. Blakeney ◽  
Herve Ouanezar ◽  
Amrut Borade ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Meniscal Repair ◽  
Anterolateral Ligament ◽  
Hamstring Tendons ◽  
Anterolateral Ligament Reconstruction ◽  
Significant Difference ◽  
Anterior Cruciate

Background: The prevalence of osteoarthritis after successful meniscal repair is significantly less than that after failed meniscal repair. Purpose: To determine whether the addition of anterolateral ligament reconstruction (ALLR) confers a protective effect on medial meniscal repair performed at the time of anterior cruciate ligament reconstruction (ACLR). Study Design: Cohort study; Level of evidence, 3. Methods: Retrospective analysis of prospectively collected data was performed to include all patients who had undergone primary ACLR with concomitant posterior horn medial meniscal repair through a posteromedial portal between January 2013 and August 2015. ACLR autograft choice was bone–patellar tendon–bone, hamstring tendons (or quadrupled hamstring tendons), or quadrupled semitendinosus tendon graft with or without ALLR. At the end of the study period, all patients were contacted to determine if they had undergone reoperation. A Kaplan-Meier survival curve was plotted, and a Cox proportional hazards regression model was used to perform multivariate analysis. Results: A total of 383 patients (mean ± SD age, 27.4 ± 9.2 years) were included with a mean follow-up of 37.4 months (range, 24-54.9 months): 194 patients underwent an isolated ACLR, and 189 underwent a combined ACLR + ALLR. At final follow-up, there was no significant difference between groups in postoperative side-to-side laxity (isolated ACLR group, 0.9 ± 0.9 mm [min to max, –1 to 3]; ACLR + ALLR group, 0.8 ± 1.0 mm [min to max, –2 to 3]; P = .2120) or Lysholm score (isolated ACLR group, 93.0 [95% CI, 91.3-94.7]; ACLR + ALLR group, 93.7 [95% CI, 92.3-95.1]; P = .556). Forty-three patients (11.2%) underwent reoperation for failure of the medial meniscal repair or a new tear. The survival rates of meniscal repair at 36 months were 91.2% (95% CI, 85.4%-94.8) in the ACLR + ALLR group and 83.8% (95% CI, 77.1%-88.7%; P = .033) in the ACLR group. The probability of failure of medial meniscal repair was >2 times lower in patients with ACLR + ALLR as compared with patients with isolated ACLR (hazard ratio, 0.443; 95% CI, 0.218-0.866). No other prognosticators of meniscal repair failure were identified. Conclusion: Combined ACLR and ALLR is associated with a significantly lower rate of failure of medial meniscal repairs when compared with those performed at the time of isolated ACLR.

Excellent bone plug–socket integration at 8 weeks after anterior cruciate ligament reconstruction using an adjustable-length loop cortical fixation device

2019 ◽  
Vol 4 (1) ◽  
pp. 9-14
Author(s):  
Ryohei Uchida ◽  
Norimasa Nakamura ◽  
Tomoyuki Suzuki ◽  
Masashi Kusano ◽  
Tatsuo Mae ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Interface Area ◽  
Cruciate Ligament Reconstruction ◽  
Significant Difference ◽  
Bone Integration ◽  
Anterior Cruciate ◽  
Bone Plug

ObjectivesRecently, adjustable-length loop cortical fixation devices (ALCFDs) have been developed. However, they are not frequently used for bone–patellar tendon–bone (BTB) grafting, mainly because it is uncertain whether an ALCFD enables sufficient integration of the bone plug. Thus, the purpose of this study was to evaluate bone plug–socket integration in anterior cruciate ligament reconstruction (ACL-R) with an ALCFD.MethodsTwenty consecutive patients with a mean age of 25±10 years underwent primary anatomic rectangular tunnel (ART) ACL-R with a BTB graft using BTB TightRope. The operated knees were evaluated by CT at 4 weeks and 8 weeks postoperatively. Union between the bone plug and the socket wall were assessed on 30 evaluation planes. No border between the plug and the socket wall, or trabecular continuity, were defined as complete union and a visible gap of >1 mm as incomplete union. When complete union was observed on >20, 11–20, 5–10 or <5 of the evaluation planes, bone integration was graded as excellent, good, fair or poor, respectively. In addition, the interface area between the plug and the socket wall was assessed by CT value index. Clinical evaluation was performed at 2 years postoperatively using the International Knee Documentation Committee (IKDC) form.ResultsThe proportion of patients with excellent bone integration was 20% at 4 weeks and 85% at 8 weeks, showing a significant difference (p=0.00015). Moreover, the CT value index of the interface area at 4 weeks was 25.8%±11.8% and that at 8 weeks was 15.3%±9.0%, again showing a significant difference (p=0.005). These suggest that bone integration of the interface area progresses over time and adequate at 8 weeks. Clinically, all 16 patients examined directly were rated their knees as normal or nearly normal with a mean side-to-side difference in anterior laxity at manual maximum force by KT-2000 of 0.2±0.3 mm.ConclusionExcellent bone plug–socket integration was observed at 8 weeks after ART ACL-R using an ALCFD with satisfactory clinical results. An ALCFD could be safely applied for ART ACL-R.Level of evidence4 (case series).

scholarly journals The Effect Of Playing Surface On Anterior Cruciate Ligament Injury In NCAA Soccer

2020 ◽  
Vol 8 (3_suppl2) ◽  
pp. 2325967120S0012
Author(s):  
Mark Howard ◽  
Hyunwoo Paco Kang ◽  
Samantha Solaru ◽  
Alexander E. Weber ◽  
Mark F. Rick C
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Soccer Players ◽  
Injury Incidence ◽  
Artificial Turf ◽  
Acl Injuries ◽  
Natural Grass ◽  
Significant Difference ◽  
Anterior Cruciate

Objectives: Previous orthopaedic literature has examined the effect of synthetic playing surfaces on the risk of anterior cruciate ligament (ACL) injury in athletes and produced varying and inconclusive results. The objective of this study was to examine the role of playing surface on the incidence and risk of ACL injury in collegiate soccer athletes. Methods: The NCAA Injury Surveillance Program (ISP) database was queried for ACL injuries for male and female soccer players from the 2004-05 through the 2013-14 seasons at all levels of competition. The number of athlete exposures (AEs), defined as 1 athlete participating in 1 practice or competition in which they were exposed to the possibility of athletic injury, were recorded for grass and synthetic playing surfaces. Both the reported injuries and exposures provided were weighted in order to represent the entire NCAA collegiate soccer population. Normalized ACL incidence rates were calculated as well as 95% confidence intervals (95%CI). Rate ratios comparing competition type amongst both competition and practice were calculated. Results: ACL injuries were more common on grass surfaces (1.16 per 10,000 AEs, 95%CI 1.12-1.20) than artificial turf (0.92 per 10,000 AEs, 95%CI 0.84-1.04). This difference was statistically significant (IRR 1.26, p<0.0001), and driven primarily by the difference in injury incidence during practice. The injury incidence during practice on natural grass (1.18 per 10,000 AEs, 95% CI 1.11-1.26) was significantly greater than the injury incidence rate during practice on artificial turf (0.067 per 10,000 AEs, 95%CI 0.043-0.096). Players were 17.7 times more likely (95%CI 10.6678-27.2187, p<0.0001) to sustain an ACL injury during practice on natural grass when compared to practice on artificial turf. However, there was no significant difference in injury incidence during matches (IRR 0.96, p=0.44), with matches on natural grass (3.35 per 10,000 AEs, 95% CI 3.21-3.51) equivalent to matches on artificial surfaces (3.49 per 10,000 AEs, 95%CI 3.18-3.81). When comparing exposure type, the injury rate was significantly greater during matches (3.38 per 10,000 AEs, 95% CI 3.25-3.52) compared to practices (0.82 per 10,000 AEs, 95%CI 0.77-0.88), with a 4.10-fold increase in ACL injury incidence during matches compared to practice (p<0.0001). Conclusion: Between 2004 and 2014, NCAA soccer players experienced a greater number of ACL injuries on natural grass playing surfaces compared with artificial turf playing surfaces. This difference is driven by injuries during practice, where athletes were nearly 18 times more likely to suffer an ACL injury on grass versus artificial turf. While ACL injuries were more likely during matches compared to practices, no difference in incidence was noted between playing surfaces. Additional study is warranted investigating potential causes for this observed increased risk with soccer practice on grass fields.

Length of the Tendon within the Tibial Tunnel Affects Tibial Tunnel Widening following Anatomic Anterior Cruciate Ligament Reconstruction Using a Bone–Patellar Tendon–Bone Graft

2019 ◽  
Vol 33 (05) ◽  
pp. 445-451
Author(s):  
Shuji Taketomi ◽  
Hiroshi Inui ◽  
Ryota Yamagami ◽  
Kohei Kawaguchi ◽  
Keiu Nakazato ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Patellar Tendon ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Pivot Shift Test ◽  
Tunnel Widening ◽  
Tendon Length ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Bone Patellar Tendon

AbstractThe purpose of this study was to retrospectively investigate the effects of variations in the length of the tendon within the tibial tunnel on tunnel widening (TW) following anatomical anterior cruciate ligament (ACL) reconstruction using a bone–patellar tendon–bone (BTB) graft. In total, 68 patients who underwent isolated ACL reconstructions using BTB grafts were included in this study. The patients were divided into two groups according to the length of the tendon within the tibial tunnel: group S (n = 30; tendon length, < 10 mm) and group L (n = 38; tendon length, ≥ 10 mm). Tunnel aperture area was measured using three-dimensional computed tomography (3D CT) at 1 week and 1 year postoperatively, and tibial TW (%) was calculated. The correlation coefficient between the length of the tendon within the tibial tunnel and tibial TW was also calculated. Clinical assessment was performed 1 year postoperatively, corresponding to the period of CT assessment, which involved the evaluation of the Lysholm's score, measurement of anterior knee stability using a KneeLax3 arthrometer, and the pivot-shift test. A weak positive correlation was observed between the length of the tendon within the tibial tunnel and tibial TW (r = 0.270, p = 0.026). Mean tibial tunnel aperture area increased by 19.3 ± 17.4% and 35.8 ± 25.4% in the groups S and L, respectively. TW in the group L was significantly greater than that in the group S (p = 0.004). No significant difference was observed between the two groups in any clinical outcomes. In conclusion, a longer tendinous portion within the tibial tunnel resulted in a greater tibial TW following anatomical ACL reconstructions using a BTB graft.

scholarly journals Reconstruction of anterior cruciate ligament by using two different techniques

2010 ◽  
Vol 63 (11-12) ◽  
pp. 845-850 ◽  
Author(s):  
Vladimir Ristic ◽  
Srdjan Ninkovic ◽  
Vladimir Harhaji ◽  
Milan Stankovic ◽  
Dragan Savic ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Bone Graft ◽  
Scoring System ◽  
Cruciate Ligament ◽  
Group Versus ◽  
International Knee Documentation Committee ◽  
Rigid Fixation ◽  
Postoperative Results ◽  
Significant Difference ◽  
Anterior Cruciate

Introduction. Modern literature concerning reconstructions of Anterior Cruciate Ligament is mostly focused on the choice of graft (hamstring or bone-tendon-bone), its placing, tensioning and fixation. The bone-hamstring-bone graft consists of compressed cancellous bone on its ends and it has been developed to achieve a more rigid fixation of the graft. The aim of this study was to compare the postoperative results in surgically treated patients two years after the reconstruction of anterior cruciate ligament. Material and methods. The study included 55 patients divided into two groups according to the implanted graft: bone-tendon-bone and bone-hamstring-bone graft. The results were assessed by Tegner and Lysholm scoring systems, arthrometric measurements, functional tests and International Knee Documentation Committee standard. Results. The average postoperative results did not show a statistically significant difference (p<0.05) between the two groups (94 in the bone-tendon-bone group versus 93 in the bone-hamstring-bone group) according to Lysholm scoring system, nor in the arthrometric measurements obtained by Lachman test (2.0:2.1). According to the International Knee Documentation Committee standard, the bone-hamstring-bone group had more excellent results, but also three unsatisfactory ones; so, the bone-tendon-bone group was found to have uniform and better results (100% of excellent and good results vs. 91% in the bone-hamstring-bone group). Better results were also recorded by Tegner scoring system in the bone-tendon-bone group (8.6 vs. 7.1) due to the fact that there were more active athletes and greater preoperative level of activities in this group (3.1 vs.7.l in the bone-hamstring group). Conclusions. The choice of graft is a less important factor in the reconstruction of anterior cruciate ligament than its placing, tensioning and fixation, because a significant difference between groups was recorded only by the International Knee Documentation Committee standard.

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