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Patellar Tendon or Hamstring Tendon to Repair ACL? Still a Toss-Up

Researchers from several large medical groups did a meta-analysis of anterior cruciate ligament (ACL) tears. They looked to see which treatment method works better: bone-patellar tendon-bone (BPTB) or hamstring tendon (HT) graft.

They found 11 reports that met the standards of this study. Problems and
benefits of each treatment type were reviewed and compared. Both methods work well. Knee pain from the donor-site of BPTB (front of knee) has led to an increased use of the HT graft. The ability to kneel without pain makes the HT graft popular.

On the other hand patients with a chronically unstable knee may prefer the BPTP. This graft has a high amount of strength and stiffness. It seems to be more stable over time. Young athletic patients are able to get back on the field or in play faster with the BPTB.

The authors conclude that each patient must decide which method is best for him or her. Personal goals can be used to decide which method will best help the patient meet those goals.


John P. Goldblatt, MD, et al. Reconstruction of the Anterior Cruciate Ligament: Meta-Analysis of Patellar Tendon versus Hamstring Tendon Autograft. In Arthroscopy. July 2005. Vol. 21. No. 7. Pp. 791-803.

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