No differences in patient-reported outcomes (PROMs) and complications after anterior cruciate ligament (ACL) reconstruction with bone–patellar tendon–bone (BPTB) or hamstrings (HT) in patients aged 50 or older

IF 2 Q2 ORTHOPEDICS

Journal of Experimental Orthopaedics Pub Date : 2025-07-18 DOI:10.1002/jeo2.70371

Rodrigo Olivieri, José I. Laso, Carlos Rojas, Nicolás Franulic, Felipe Bustos, Roberto Oyarce, Nicolás Gaggero, Alberto Grassi

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Abstract

Purpose

This study aimed to compare postoperative clinical outcomes, including patient-reported outcome measures (PROMs), patellofemoral symptoms, and complications, in patients over 50 years old who underwent anterior cruciate ligament (ACL) reconstruction with either bone–patellar tendon–bone (BPTB) or hamstring tendon (HT) autografts. We hypothesised no significant differences in outcomes between the two techniques in this age group.

Methods

A retrospective cohort study was conducted using institutional records of patients over 50 years old who underwent isolated ACL reconstruction (defined as ACL reconstruction without associated ligament injuries), with or without concomitant meniscal procedures, using BPTB or HT autografts between January 2016 and December 2022, with a minimum follow-up of two years. Postoperative outcomes were assessed using PROMs, including the Lysholm score, Kujala score, and the Knee injury and Osteoarthritis Outcome Score Quality of Life subscale (KOOS QoL), complication rates, and the need for revision surgery. Statistical analyses included independent t-tests, Mann–Whitney U tests, chi-square tests and multivariate regression analyses.

Results

A total of 83 patients met the inclusion criteria (45 HT and 38 BPTB). The mean age was 53.5 years (SD 3.0), with a mean follow-up of 56.3 months. No significant differences were found in Lysholm (HT: 83.1, BPTB: 86.1; p = 0.934), Kujala (HT: 82.2, BPTB: 84.5; p = 0.901), or KOOS QoL scores (HT: 69.0, BPTB: 68.7; p = 0.649). The incidence of complications and the need for revision surgery were similar between groups.

Conclusions

ACL reconstruction in patients over 50 years old using BPTB or HT autografts resulted in comparable clinical outcomes, PROMs, and complication rates. In this cohort, graft type did not appear to significantly influence postoperative results.

Level of Evidence

Level III, retrospective cohort study.

Abstract Image

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在50岁及以上的患者中，采用骨-髌腱-骨（BPTB）或腘绳肌（HT）重建前交叉韧带（ACL）后，患者报告的预后（PROMs）和并发症无差异

目的：本研究旨在比较50岁以上接受骨-髌腱-骨（BPTB）或腘肌腱（HT）自体移植前交叉韧带（ACL）重建的患者的术后临床结果，包括患者报告的预后指标（PROMs）、髌骨症状和并发症。我们假设两种技术在这个年龄组的结果没有显著差异。方法回顾性队列研究采用2016年1月至2022年12月间采用BPTB或HT自体移植物进行孤立前交叉韧带重建（定义为无相关韧带损伤的前交叉韧带重建）的50岁以上患者的机构记录，随访时间至少为两年。使用PROMs评估术后结果，包括Lysholm评分、Kujala评分、膝关节损伤和骨关节炎结局评分生活质量亚量表（kos QoL）、并发症发生率和翻修手术的需要。统计分析包括独立t检验、Mann-Whitney U检验、卡方检验和多元回归分析。结果83例患者符合纳入标准（45例HT， 38例BPTB）。平均年龄53.5岁（SD 3.0），平均随访56.3个月。Lysholm (HT: 83.1, BPTB: 86.1；p = 0.934), Kujala (HT: 82.2, BPTB: 84.5；p = 0.901)，或kos QoL评分(HT: 69.0, BPTB: 68.7；p = 0.649)。并发症的发生率和翻修手术的需要在两组之间相似。结论：50岁以上患者使用BPTB或HT自体移植物进行ACL重建的临床结果、PROMs和并发症发生率相当。在这个队列中，移植物类型似乎对术后结果没有显著影响。证据水平III级，回顾性队列研究。

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