New research shows patellar tendon, hamstring tendon, and double–bundle techniques offer similar outcomes, though re–injury rates are higher for hamstring tendon and double–bundle techniques.

The most common surgical techniques used to repair a torn anterior cruciate ligament (ACL) offer patients improved quality of life five years after injury, according to research presented at the American Orthopaedic Society for Sports Medicine’s Annual Meeting in Toronto, Ontario, Canada. The study followed patients for five years following surgery.

“Orthopaedic surgeons have a variety of surgical techniques available to reconstruct a torn ACL,” commented corresponding author and presenter Nicholas Mohtadi, MD, MSc, FRCSC, from the University of Calgary Sport Medicine Centre. “Our research showed patients overwhelmingly see improvements with the patellar tendon, hamstring tendon, and double–bundle surgical techniques, though re–injuries are more common in the hamstring tendon and double–bundle approach. Re–injuries rates approach 30% in younger active patients. Our main focus should be to prevent these injuries.”

Researchers studied 315 randomized patients, who all completed the five year–follow–up. Patients were randomly assigned one of the surgical approaches defined. Follow–up occurred at three and six months, and then one–, two– and five– years post–operation by an independent trained examiner, who was also blinded to the approach used. Primary outcomes evaluated included patient–reported Anterior Cruciate Ligament Quality of Life (ACL–QOL), a 32–item questionnaire.

“Our research is exciting as it represents the only double–blind, randomized clinical trial with this large of a sample size, and a mid–term follow–up rate of five years,” noted Mohtadi. “We hope this data can continue to help physicians manage patient care and treatment of ACL injuries.”