Athletes With Bone-Patellar Tendon-Bone Autograft for Anterior Cruciate Ligament Reconstruction Were Slower to Meet Rehabilitation Milestones and Return-to-Sport Criteria Than Athletes With Hamstring Tendon Autograft or Soft Tissue Allograft : Secondary Analysis From the ACL-SPORTS Trial.
Angela Hutchinson Smith, Jacob J Capin, Ryan Zarzycki and 1 others
PMID 31775553WHAT IT FOUND
Athletes with bone-patellar tendon-bone grafts took 1.5 to 2.5 months longer to meet rehab milestones and up to 4 months longer to return to sport than those with hamstring autografts or allografts.
They also had lower quadriceps strength after training, though outcomes equalized by one year.
Key findings
01Bone-patellar tendon-bone grafts delayed meeting enrollment and return-to-sport criteria compared to hamstring autografts and allografts.
02After the return-to-sport program, the bone-patellar tendon-bone group had lower quadriceps strength indices than the other groups.
03By one year post-surgery, there were no differences in clinical outcomes between the graft types.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The allograft group was older and had more men, while the BPTB group had more women, introducing potential confounding factors despite statistical adjustment. Early post-operative rehabilitation prior to enrollment was not standardized and took place at multiple clinics. This is a secondary analysis of a pre-existing dataset, not a trial designed primarily to compare graft types. Not all participants completed hop testing at post-training due to effusion or pain, which may bias the functional data.
Declared interests
The authors declared no financial affiliations or conflicts of interest.
The easy way to misread this
Do not conclude that BPTB grafts are inferior overall. Although recovery was slower and initial strength lower, all graft types reached equivalent clinical outcomes by one year, and BPTB grafts may offer lower re-injury risks due to the delayed return to sport.