Patellar Tendon or Leeds-Keio Graft in the Surgical Treatment of Anterior Cruciate Ligament Ruptures

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Abstract
In a prospective randomized study, 60 patients with unilateral chronic anterior cruciate ligament (ACL) rupture were allocated to surgical reconstruction using an autogenous patellar tendon graft (PT) or a synthetic Leeds-Keio graft (LK). Fifty-five patients (26 PT, 29 LK), 32 men, 23 women, fulfilled the criteria to be further tested. The mean time from surgery to follow up was 28 months. Laxity was tested by pivot shift and an instrumented anterior laxity test. Subjective knee function was classified using the Lysholm score, Tegner activity score, and IKDC grading. Muscle performance was analyzed in 49 patients (23 PT, 26 LK. There was no difference between the two groups in anthropometry, activity levels (before trauma; present; desired activity), time from trauma to surgery, or time from surgery to follow-up evaluation. Neither the concentric and eccentric knee extensor peak torque ratio nor the knee extensor endurance and the one-leg hop test differed between the two groups. However, both the pivotshift and the anterior laxity were significantly greater for the LK group. On the other hand, significantly more patients in the PT group had an extensor lag. Although the results are only intermediate, the Leeds-Keio ligament does not fulfill the requirements for a satisfactory result in ACL reconstructive surgery with regard to knee-joint stability.

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