Abstract
The objective of this study was to provide a comprehensive systematic review and meta-analysis
to compare patient-reported outcomes and functional knee parameters of anterior cruciate
ligament (ACL) reconstruction surgery with semitendinosus (ST) and ST-gracilis (G)
grafts. This study was conducted according to Preferred Reporting Items for Systematic
Reviews and Meta-Analyses (PRISMA) and Meta-Analysis of Observational Studies in Epidemiology
(MOOSE) guidelines. All studies in PubMed and Embase that reported functional knee
parameters and patient-reported outcomes after ACL reconstruction with ST and ST-G
grafts independently were included in the review. Selected end points for random effects,
pairwise meta-analysis included side-to-side deficit (%) in isokinetic peak torque,
peak torque ratio (%), side-to-side difference (mm) in anterior laxity, and patient-reported
outcome scores at minimum 2-year follow-up. A total of 15 primary references comprising
1,109 participants were identified. The ST group had decreased side-to-side deficit
in isokinetic peak torque when compared with the ST-G group for flexion at 60 degrees/s
(p = 0.02) and 180 degrees/s (p = 0.01) at 2-year follow-up. There were no significant differences in side-to-side
difference in anterior laxity (p = 0.81), hamstring/quadriceps peak torque ratios at 60 degrees/s (p = 0.83) and 180 degrees/s (p = 0.36), and patient-reported outcomes in the International Knee Documentation Committee
score (p = 0.06) and Lysholm score (p = 0.67). The addition of the gracilis tendon to the hamstring autograft in ACL reconstruction
results in increased side-to-side deficits in isokinetic peak flexion torque. However,
patient-reported outcome scores and knee laxity measurements are comparable with those
of ST grafts.
Keywords
ACL reconstruction - hamstring graft - patient-reported outcomes
