Higher Rate of Patellofemoral Problems After Anterior Cruciate Ligament Reconstruction using Hamstring Autograft

Krisna Yuarno Phatama; Romy Darmawansa; I Gusti Ngurah Arga Aldrian Oktafandi; Felix Cendikiawan; Alva Pribadi; Lasa Dhakka Siahaan; Sholahuddin Rhatomy; Edi Mustamsir

doi:10.3889/oamjms.2021.6626

Authors

Krisna Yuarno Phatama Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Brawijaya, RSUD Dr. Saiful Anwar, Malang, East Java, Indonesia https://orcid.org/0000-0003-1050-7561
Romy Darmawansa Department of Orthopaedics and Traumatology, RSUD Dr. H. Andi Abdurrahman Noor, Tanah Bumbu, South Borneo, Indonesia
I Gusti Ngurah Arga Aldrian Oktafandi Department of Orthopaedics and Traumatology
Felix Cendikiawan Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Brawijaya, RSUD Dr. Saiful Anwar, Malang, East Java, Indonesia
Alva Pribadi Department of Orthopaedics and Traumatology
Lasa Dhakka Siahaan Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Brawijaya, RSUD Dr. Saiful Anwar, Malang, East Java, Indonesia
Sholahuddin Rhatomy Department of Orthopaedics and Traumatology, Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada, RSUP Dr. Soeradji Tirtonegoro, Klaten, Central Java, Indonesia
Edi Mustamsir Department of Orthopaedics and Traumatology, Faculty of Medicine, Universitas Brawijaya, RSUD Dr. Saiful Anwar, Malang, East Java, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2021.6626

Keywords:

Anterior cruciate ligament reconstruction, Patellofemoral, Hamstring, Peroneus longus, Kujala

Abstract

Background: Patellofemoral problems are not uncommon among post-anterior cruciate ligament (ACL) reconstruction patients. Hamstring autograft harvesting-related factor is one of the suspected causes. A lack of tibiofemoral internal rotation force due to strength deficit causes the patella tends to shift laterally.

Purposes: Peroneus longus tendon has been proposed as an alternative graft source due to its adequate tensile strength and minimal donor site morbidity to the knee biomechanics, including the patellofemoral joint. This tendon does not cross the knee joint and thus does not affect patellofemoral alignment and biomechanics. This study aims to compare patellofemoral problems between hamstring and peroneus longus autograft harvested-patients following ACL reconstruction.

Material and methods: Thirty-one subjects who underwent primary single-bundle ACL reconstruction between September 2018 and September 2019 and met the inclusion criteria were grouped into the hamstring group (n=16) and peroneus longus group (n=15). Both groups were evaluated retrospectively. The follow-up assessment was conducted on the phase II rehabilitation program. The assessed variables were pain, crepitus, and the Indonesian-validated Kujala score.

Results: No significant differences in pain and crepitus were found between both groups. There were significant differences in the Kujala score between both groups (P < .001). The peroneus longus group reported an averagely higher score than the hamstring group.

Conclusion: Single bundle ACL reconstruction using peroneus longus tendon autograft produces less patellofemoral symptoms and functional limitation than using hamstring tendon autograft.

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