자가 골 - 슬개건 - 골 및 슬괵건을 이용한 전방십자인대 재건술후 결과 비교

송은규(Eun Kyoo Song),설종윤(Jong Yoon Seol),윤택림(Taek Rim Yoon) 대한슬관절학회 2000 대한슬관절학회지 Vol.12 No.2

Purpose : To compare the clinical and radiologic results of the anterior cruciate ligament(ACL) recon- struction between bone-patellar tendon-bone autograft and doubled semitendinosus and gracilis autograft Materials and Methods: 45 patients out of 235 ACL reconstructions with bone-patellar tendon- bone(BPTB) autograft and 47 patients out of 178 ACL reconstructions with doubled semitendinosus and gracilis were included in this study. Average follow-up period were 19 months in BPTB autograft and 17 months in doubled semitendinosus and gracilis autograft. There were no differences in preoperative parameters(age, sex, instability). Results: There were no significant differences between two groups with respect to functional result(Lysholm knee score), degree of laxity and range of motion at final follow-up. However, the parap- atellar complications, especially anterior knee pain after long distance walking or exercise, and quadriceps weakness were less occurred in doubled semitendinosus and gracilis autograft than in BPTB autograft. Conclusion : ACL reconstruction with doubled semitendinosus and gracilis autograft is a good alternative choice in reducing parapatellar complications and in achieving functional stability of knee joint.

An inside-out vein graft filled with platelet-rich plasma for repair of a short sciatic nerve defect in rats

Kim, Ji Yeong,Jeon, Woo Joo,Kim, Dong Hwee,Rhyu, Im Joo,Kim, Young Hwan,Youn, Inchan,Park, Jong Woong Medknow PublicationsMedia Pvt Ltd 2014 Neural regeneration research Vol.9 No.14

<P>Platelet-rich plasma containing various growth factors can promote nerve regeneration. An inside-out vein graft can substitute nerve autograft to repair short nerve defects. It is hypothesized that an inside-out vein graft filled with platelet-rich plasma shows better effects in the repair of short sciatic nerve defects. In this study, an inside-out vein autograft filled with platelet-rich plasma was used to bridge a 10 mm-long sciatic nerve defect in rats. The sciatic nerve function of rats with an inside-out vein autograft filled with platelet-rich plasma was better improved than that of rats with a simple inside-out vein autograft. At 6 and 8 weeks, the sciatic nerve function of rats with an inside-out vein autograft filled with platelet-rich plasma was better than that of rats undergoing nerve autografting. Compared with the sciatic nerve repaired with a simple inside-out vein autograft, the number of myelinated axons was higher, axon diameter and myelin sheath were greater in the sciatic nerve repaired with an inside-out vein autograft filled with platelet-rich plasma and they were similar to those in the sciatic nerve repaired with nerve autograft. These findings suggest that an inside-out vein graft filled with platelet-rich plasma can substitute nerve autograft to repair short sciatic nerve defects.</P>

성공적인 전방십자인대 재건술을 위한 적절한 이식건의 선택

경희수(Hee-Soo Kyung) 대한정형외과학회 2021 대한정형외과학회지 Vol.56 No.1

성공적인 전방십자인대 재건술을 얻기 위해 수술 전 계획, 수술수기, 수술 후 재활 등 여러 가지 요소가 관여한다. 그리고 좋은 결과를 얻기 위해서 수술 중 이식건의 선택, 고정, 처리 방법, 성숙, 본체골에 병합, 장력 등을 고려해야 한다. 이식건을 선택할 때 이식건의 강도, 이식건의 고정방법, 고정부위 치유, 공유 부위 이환, 이식건의 표면적 크기 등을 고려해야 한다. 이식건에는 자가건과 동종건의 두 가지가 있다. 자가 슬개건, 슬괵건, 대퇴사두건 등 사용할 수 있는 자가건은 여러 가지가 있으며 각각의 장·단점을 가지고 있다. 최근 국내에서 동종건의 사용빈도가 높아지고 있는데 공여부의 이환이 없고, 수술 시간이 짧고, 수술 후 통증이 적고, 재료가 다양한 장점이 있다. 하지만 동종건이 자가건보다 장기간 추적 결과가 더 좋다는 보고는 없다. 동종건은 골과의 합병이 오래 걸리고, 불완전하며, 인대 재형성이 늦고, 생역학적으로 자가건보다 강도가 낮으며, 면역반응의 위험성이 높고, 질병 전파의 가능성 등 원초적인 제한점을 가지고 있다. 그래서 장기간 결과에서 실패율이 높고 이식건의 성숙도가 자가건보다 좋지 않다. 그러므로 동종건은 자가건의 대용이 될 수 있지만 자가건을 사용할 수 없을 때, 여러 가지 인대 재건술이 필요한 경우를 제외하고 자가건을 사용하도록 하는 것이 좋다. 만약 적절한 크기와 굵기의 자가건을 얻을 수 있다면 자가건을 사용한 적절한 고정방법을 선택하고 수술 후 재활을 하면 동종건을 사용한 결과보다 우수한 결과를 얻을 것으로 생각된다. Several factors need to be considered for a successful anterior cruciate ligament (ACL) reconstruction, such as preoperative planning, operation technique, and postoperative rehabilitation. Graft choice, fixation, preparation method, maturation, incorporation to host bone, and graft tension should also be considered to achieve a good outcome after an ACL reconstruction. Factors to consider when selecting a graft are the graft strength, graft fixation, fixation site healing, and donor site morbidity, as well as the effects of initial strength, size, surface area, and origin of the graft on its potential for weakening during healing. There are two types of graft for an ACL reconstruction, autograft or allograft. Several autografts have been introduced, including the bone-patellar tendon-bone, hamstring tendon, and quadriceps tendon-bone. On the other hand, each has its advantages and disadvantages. The recent increased use of allografts for an ACL reconstruction is the lack of donor site morbidity, decreased surgical time, diminished postoperative pain, and good availability of source. Despite this, there are no reports suggesting that an allograft may have a better long-term outcome than an autograft. Allografts have inherent disadvantages, including a longer and less complete course of incorporation, remodeling, biomechanically inferiority to autograft, the potential risk of an immunogenic reaction and disease transmission. Higher long-term failure rates and poorer graft maturation scores were reported for allografts compared to autografts. An autograft in an ACL reconstruction should remain the gold standard, although the allograft is a reasonable alternative. If adequate length and diameter of autograft can be obtained for an ACL reconstruction, an autograft with adequate graft fixation and postoperative rehabilitation should be chosen instead of an allograft to achieve better results.

공막연화증에서 조직접합제를 이용한 공막이식술, 자유자가결막이식술 및 일시적 양막이식술

최원석,이광자,박영정,이규원,Won Suk Choi,Gwang Ja Lee,Young Jeung Park,Kyoo Won Lee 대한안과학회 2011 대한안과학회지 Vol.52 No.12

Purpose: To evaluate the surgical results and complications arising from scleral graft and free conjunctival autograft using tissue adhesive and temporary amniotic membrane transplantation as the surgical treatment for scleromalacia. Methods: Scleral graft and free conjunctival autograft using tissue adhesive and temporary amniotic membrane transplantation was performed in 20 eyes of 20 patients with scleromalacia caused by pterygium excision. The surgical results and complications arising from the procedure were monitored and analyzed through follow-up. Results: During the follow-up period of 17.6 ± 5.9 months, the wound injection and edema at the free conjunctival autograft and operation site healed in all the cases except 1 at postoperative 1 month. The stability of the ocular surface for graft transplantation was maintained at postoperative 3 months. Although a partial absorption of the conjunctival autograft induced by careless treatment occurred 2 weeks postoperative in 1 case, the ocular surface stabilized due to suitable treatment after 6 months. Although the edges of the scleral graft in 3 patients were partially absorbed 6 months postoperatively, the ocular surface stability was maintained by covering the conjunctival autografts. Conclusions: For scleromalacia patients, scleral graft and free conjunctival autograft using tissue adhesive and temporary amniotic membrane transplantation rapidly stabilized the ocular surface and presented excellent aesthetic results. J Korean Ophthalmol Soc 2011;52(12):1405-1413

골수강내 혈관성 근피판 이식이 동결 건조후 자가 이식된 관절연골의 재생에 미치는 효과

이승구,김성태,박진일,Rhee, Seung-Koo,Kim, Sung-Tae,Park, Jin-Il 대한미세수술학회 2000 Archives of reconstructive microsurgery Vol.9 No.2

The aim of this study was to assess whether the functional regeneration of a lyophilized autografted cartilage could be improved by implanting a vascularized muscle flap into the medullary canal of autografted proximal humerus. A hemijoint reconstruction using a lyophilized osteochondral autograft in proximal humerus was done in 4 rabbits for control, and combined with an vascularized intramedullary muscle flap in another 4 rabbits for the experimental group. Graft healing and the repair process of osteochondral graft were followed by serial radiographs and histologic changes for 9 weeks after experiments. Each two rabbits in control and in experimental group on 5th and 9th week after implantation of hemijoint were sacrified. The results were as follows: 1. All of control and experimental froups on 5th week united solidly on osteotomized site radiologically, but their articular cartilages were destroyed more seriously in the control than that in experimental group with muscle flap on 5th and 9th week after experiment... 2. Histochemically, the cartilage surface are completely destroyed and revealed with severe osteoarthritic changes on all cartilage layers in control, but cartilaginous erosions are mild to moderate and their arthritic changes are also mild with somewhat regeneration of chondrocytes on deep layers more prominetly on 9th week of the experimental group. 3. The amount of collagen and protenized matrix which was determined by Masson-Trichrome stain was markedly decreased that means the weakness of bony strength and low osteogenic potential in lyophilized cartilage. These results suggest that an intramedullary vascularized muscle flap can improve the functional results of lyophilized osteochondral autograft by providing both increased vascularity and populations of mesenchymal cells to initiate new bone formation on osteotomized site as well as the regeneration of deep layers in articular cartilage. In clinical relevances, this lyophilized hemijoint autograft combined with an intramedullary vascularized muscle pedicle graft might be used very effectively for the treatment of malignant long bone tumors to preserve the joint functions, all or partly, and so to replace it with the artificial joint after tumor excision and hemijoint autograft.

자가결막편 이식술을 이용한 원발성 군날개 수술의 임상성적

김동익,김미금,위원량,오주연 대한안과학회 2015 대한안과학회지 Vol.56 No.6

목적: 자가결막편 이식술을 이용한 원발성 군날개 수술의 임상성적을 알아보고자 하였다. 대상과 방법: 군날개 절제술 및 자가결막편 이식술을 시행받은 원발성 군날개 환자 112명, 129안의 의무기록을 후향적으로 조사하여 군날개 절제술 및 양막이식술, 결막피판술, 단순결막봉합술을 시행받은 환자 28명, 32안의 수술 성적과 비교하였다. 또한 자가결막편이식술을 이용한 군날개 수술 중 마이토마이신 C 점적을 동반한 경우와 동반하지 않은 경우의 수술 성적을 비교하였다. 결과: 군날개 절제술 및 자가결막편 이식술을 시행받은 원발성 군날개 129안 중 3안(2.3%)에서 재발하였다. 반면 군날개 절제술 및양막이식술을 시행받은 10안 중 2안(20.0%), 군날개 절제술 및 결막피판술을 시행받은 10안 중 1안(10.0%), 군날개 절제술 및 단순결막봉합술을 시행받은 12안 중 1안(8.3%)에서 재발이 관찰되어 자가결막편 이식을 이용한 수술에서 자가결막편 이식을 이용하지 않은경우보다 유의하게 군날개 재발률이 적었다(p=0.024, Breslow‐Wilcoxon 법). 또한 군날개 절제술 및 자가결막편 이식술 도중 마이토마이신 C 점적을 사용한 10안 중 1안(10.0%)에서 군날개가 재발하였고, 마이토마이신 C를 사용하지 않은 군날개 절제술 및 자가결막편 이식술을 받은 119안 중 2안(1.7%)에서 군날개가 재발하였다. 결론: 원발성 군날개의 치료로 자가결막편 이식술을 이용한 군날개 절제술은 낮은 재발률과 적은 합병증을 보이는 유용한 치료법으로 생각된다. Purpose: To investigate the clinical outcomes of primary pterygium excision combined with free conjunctival autograft. Methods: The medical records of 112 patients (129 eyes) who underwent pterygium excision and free conjunctival autograft for primary pterygium were retrospectively reviewed for recurrence and postoperative complications and the outcomes compared with pterygium excision combined with amniotic membrane transplantation, conjunctival flap, or simple conjunctival closure.Additionally, the surgical outcomes were evaluated in relation to the intraoperative use of mitomycin C. Results: Postoperative recurrences were observed in 3 of 129 eyes (2.3%) that received pterygium excision and free conjunctival autograft, 2 of 10 eyes (20.0%) that received pterygium excision with amniotic membrane transplantation, 1 of 10 eyes(10.0%) that received pterygium excision with conjunctival flap and 1 of 12 eyes (8.3%) that received pterygium excision and simple conjunctival closure. Therefore, the recurrence rate was significantly lower in patients with conjunctival autograft than in those without (p = 0.024, Breslow-Wilcoxon test). Additionally, recurrence was observed in 1 of 10 eyes (10.0%) in patients that underwent pterygium surgery when mitomycin C was used intraoperatively and in 2 of 119 eyes (1.7%) without the use of mitomycin C. Conclusions: Pterygium excision combined with free conjunctival autograft is an effective and safe surgical procedure to treat primary pterygium.

자가윤부결막이식술을 시행한 원발군날개에서 마이토마이신 C의 효용성에 대한 임상연구

이병희,이종욱,박영정,이규원 대한안과학회 2009 대한안과학회지 Vol.50 No.7

Purpose: To evaluate the effectiveness of Mitomycin C used as a combined therapy along with limbal-conjunctival autograft for primary pterygium. Methods: Thirty eyes of 29 patients received Mitomycin C (0.02% MMC 3 minutes) with limbal-conjunctival autograft, and 30 eyes of 28 patients received limbal-conjunctival autograft alone. Recurrence and complications were evaluated in the patients at 2 weeks, 1, 3, 6 and 12 months postoperatively. Results: Mean follow-up periods were 13.4±2.1 and 13.9±2.9 months, respectively. Between the two groups, recurrence in the conjunctiva or the cornea was not observed during the follow-up period. In the Mitomycin C use group, complications included a granuloma at the donor site (1 eye, 3.3%), wound dehiscence (2 eyes, 6.7%), and subgraft hemorrhage (2 eyes, 6.7%). In comparison, in the group treated with limbal-conjunctival autograft alone, complications included granuloma at the donor site (1 eye, 3.3%), pseudopterygium at the donor site (1 eye, 3.3%), wound dehiscence (3 eyes, 10%), and subgraft hemorrhage (2 eyes, 6.7%). Conclusions: The use of Mitomycin C as an adjuvant therapy has no significant effect on the recurrence rate in primary pterygium with limbal-conjunctival autograft. 목적: 원발군날개에서 자가윤부결막이식술시 Mitomycin C 보조요법의 효용성에 대해 알아보고자 한다. 대상과 방법: 원발군날개 환자를 대상으로 광범위 군날개 절제술과 생체조직접합제를 사용하여 자가윤부결막이식을 시행한 경우에서 수술 중 0.02% Mitomycin C 3분을 사용한 군 29명(30안)과 사용하지 않은 군 28명(30안)에서 술 후 2주, 1, 3, 6, 12개월 간격으로 군날개 재발 유무와 시술에 따른 합병증을 비교 관찰하였다. 결과: 추적관찰 기간 중 두 군 모두 결막이나 각막 재발은 관찰되지 않았다. 합병증으로 Mitomycin C 사용군에서 테논낭 육아종 1안 (3.3%), 상처 벌어짐 2안(6.7%), 이식된 결막편하 출혈 2안(6.7%), Mitomycin C 사용하지 않은 군에서 테논낭 육아종 1안(3.3%), 공여부 가성군날개 1안(3.3%), 상처 벌어짐 3안(10%), 이식된 결막편하 출혈 2안(6.7%)에서 관찰되었다. 결론: 원발군날개 환자에서 광범위 군날개 절제술과 자가윤부결막이식술을 시행할 경우 Mitomycin C 보조요법의 사용여부는 재발률과 합병증에 유의한 영향이 없었다.

Comparing Allografts to Autografts for Maintenance of Cervical Sagittal Parameters and Clinical Outcomes Following Anterior Cervical Discectomy and Fusion With Anterior Cervical Plating

Steven Thomas Heidt,Philip King-Hung Louie,Jannat M. Khan,Bryce A. Basques,Brandon Hirsch,Arya Varthi,Justin C. Paul,Edward J. Goldberg,Howard S. An 대한척추신경외과학회 2019 Neurospine Vol.16 No.3

Objective: Current literature has not shown if using either allograft or autograft differentially affects postoperative cervical sagittal parameters. The goal of this study was to compare sagittal alignment and patient-reported outcomes following anterior cervical discectomy and fusion (ACDF) with allograft versus autograft. Methods: A retrospective cohort analysis of patients who underwent single-level ACDF was conducted. Preoperative, immediate postoperative, and final follow-up radiographic assessments were conducted and included: change in C2–7 lordosis, T1 slope, levels fused, sagittal vertical axis (SVA), fusion mass lordosis, and proximal and distal adjacent segment degeneration (ASD). Patient-reported outcomes were obtained using the Neck Disability Index and visual analogue scale scores for neck and arm. Results: A total of 404 patients were assessed; 353 using allograft and 51 using autograft. No significant differences existed in demographics. Cervical lordosis improved in both groups without significant changes in SVA. Autograft group had a significantly greater amount of lordosis at the proximal segment on immediate postoperative radiographs and less overall cervical lordosis at final follow-up. Sagittal parameters were similar at each time point without significant changes between the 3-time points. No significant differences existed in radiographic ASD or reoperation rates. Fusion rates exceeded 96% in both groups. No significant differences existed between preoperative, postoperative, or change in patient-reported outcomes between the 2 groups. Conclusion: Sagittal alignment is maintained following ACDF when using either allograft or autograft. Radiographic evidence of ASD is present in both groups; however, this was not considered clinically significant, given low rates of pseudarthrosis or reoperation. No significant differences exist between groups in terms of patient-reported outcomes.

가토 장관골 결손부의 치유과정에 골이식 방법이 미치는 영향에 관한 실험적 연구

박상원,강오영 고려대학교 의과대학 1996 고려대 의대 잡지 Vol.33 No.2

Bone grafts are used in the repair segmental bone loss caused by severe trauma, bone tumors and infection and to enhance bone healing in ununited fractures. Autograft is the most requently used and the most effective method, but because of inadquate supply and additional operative morbidity, allograft or heterograft must be used. Allograft are often complicated by immunognic rejection, fractue, resorption, infection and non-union. Heterograft has been shown to be poorly tolerated by the host and ineffective in prviding an osteogenic system. The objective of this study is to observe healing process of a segmental defect of long bond following to various bone graft methods, and to compare the difference of histologic process between autograft, and allograft or hetero graft. Thirty-two white rabbit weighing 1,000 to 2,000 grams were used for an experiment. A segment(1.5-2.0cm_ measuring three times the diameter of ulna shaft of rabbit was resected with its periosteum. Thirty-two white rabbit were divided into following four groups according to graft methods, each group comprising of eight rabbits. Control(Defect) group : The group that ulna defect was not grafted heterograft group : The group that ulna defect was grafted with Osteovit® (B.braun Co. Germany) of bovine origins. Allograft group : The group that ulna defect was grafted with resected bone of ulna from the other rabbits. Autograft group : The group that ulna defect was grafted with resected bone of ulna of the same rabbit The rabbits were sacrificed at 2, 4, 8 and 12 weeks after the experimental procedures and periodically evaluated by gross appearance, radiographs, histology and immunohistochemistry for osteonectin. The obtained results were as follows: 1. The gross and radiological findings showed that ungrafted ulnar defects(control group) was not healed. In the heterograft group, partial union of the host-graft bone began from 8 weeks and complete union was obtained on 12 weeks. In the allograft group, partial union was began from 2 weeks and complete union was obtained on 8 weeks. In the autograft group, partial union was began from 2 weeks, complete union was obtained on 4 weeks. 2. The histological findings showed that the ungrafted ulnae did not heal across the defect but some immature trabeculae were founded on the edges of the defect. In the heterograft group, immature trabeculae were appeared from 4 weeks and defects were substituted with mature trabeculae on 12 weeks. In the allograft group, immature trabeculae were appeared from 2 weeks and mature trabeculae on 8 weeks. In autograft group, defects were substituted with immature trabeculae on 2 weeks and with mature trabeculae on 4 weeks. 3. The immunohistochemical study of the osteonectin showed that moderate staining was found on the subperiosteal new bone and immature woven bone, but cartilage was not stained to the osteonectin. Immature trabeculae were stained more strongly than the mature trabeculae. As seen in the results of the experiment, union of the host and graft bone could be obtained with the heterograft or allograft, but needed more time than the healing period of the autograft. The healing process of the heterograft or the allograft was similar to the autograft on the histologic findings. The immunohistochemical study for the osteonectin seems to be the useful method for the evaluation of the ability of new bone formation after bone grafting.

자가 슬건과 슬개건을 이용한 관절경적 전방십자인대 재건술의 단기 추시 결과 비교

서재성(Jae Sung Seo),이동철(Dong Chul Lee),손욱진(Oog Jin Shon),장우혁(Woo Hyuk Jang),김세동(Se Dong Kim) 대한정형외과학회 2006 대한정형외과학회지 Vol.41 No.1

목적: 자가 슬건과 슬개건을 이용한 관절경적 전방십자인대 재건술의 술후 결과를 임상적, 방사선적으로 분석하여 비교하여 비교하고자 하였다. 대상 및 방법: 1997년 9월부터 2003년 1월까지 전방십자인대 재건술을 시행받은 환자들 중 추시기간이 18개월 이상인 자가 슬건 군 22예와 자가 슬개건 군 30예를 대상으로 하였다. 임상적 평가는 IKDC 평가법, Lysholm 점수, Tegner 점수를 이용하였으며 방사선적 평가는 Telos기기를 이용하여 90도 굴곡위에서 전방 전위도를 정상측과 비교하였고 무릎을 꿇은 상태에서 나타나는 전방 슬부 동통의 빈도, 대퇴 사두근의 위축 정도 등을 비교하였다. 결과: IKDC 평가법에 의하면 슬건 군은 A등급 2예, B등급 14예, C등급 6예였고 슬개건 군은 A등급 3예, B등급 20예, C등급 7예로 두 군간에 차이가 없었다. Lysholm 점수는 슬건 군이 술 전 평균 58.2점에서 최종 추시상 평균 88점으로, 슬개건 군은 평균 56.3점에서 평균 90.6점으로 호전되었고, Tegner 점수는 슬건 군이 술 전 평균 2.4점에서 최종 추시상 평균 5.8점으로, 슬개건 군은 평균 2.3점에서 평균 6.2점으로 활동도가 증가되었으나 두 군 간에 차이가 없었다. Telos기기를 이용한 최종 추시 전방 전위도는 슬건 군이 정상측과 평균 2.6 ㎜의 차이를 보였고 슬개건 군이 평균 2.3 ㎜의 차이를 보여 두 군간에 차이가 없었다. 무릎을 꿇은 상태에서 나타나는 전방 슬부 동통은 슬건 군이 2예(13%), 슬개건 군이 11예(37%)로 통계적인 차이를 보였다(p<0.05). 결론: 슬건을 이용한 관절경적 전방십자인대 재건술은 무릎을 꿇은 상태에서 나타나는 전방 슬부 동통의 빈도를 낮출 수 있으며 슬개건과 비슷한 정도의 만족할 만한 인대 안정성 및 임상적 결과를 얻을 수 있었다. Purpose: To evaluate the stability, activity level and clinical results of an autologous hamstring and Bone-patellar tendon-bone (BPTB) graft in an Anterior cruciate ligament (ACL) reconstruction. Materials and Methods: Between September 1997 and January 2003, 22 patients with an ACL reconstruction with an autologous four strand hamstring tendon, and 30 patients with a BPTB autograft were enrolled in this study. At the time of the final follow-up, the patients were evaluated by stress radiographs using a Telos instrument, the Lysholm score, Tegner activity score, IKDC activity grades, and anterior kneeling pain. Results: An evaluation of the anterior laxity using the Telos instrument revealed no significant difference in the hamstring and BPTB groups: side to side difference 2.6 ㎜ in the hamstring group vs 2.3 ㎜ in the BPTB groups (p>0.05). The Lysholm score improved from a preoperative score of 58 to a postoperative score of 88 in the hamstring groups and from 56 to 91 in the BPTB groups. The Tegner score for the hamstring groups was 2.4 preoperatively and 5.8 at the final follow up, and the Tegner score for the BPTB groups were 2.3 and 6.2 preoperatively and after the last follow-up, respectively. The Tegner score was similar in the two treatment groups (p>0.05). According to the IKDC rating system, 9% were normal and 64% were almost normal in the hamstring group. In the BPTB group, 10% were normal and 67% were almost normal. Anterior kneeling pain after a reconstruction with the hamstring tendon autograft (13%) was significantly less common than with the patellar tendon autograft (37%)(p<0.05). Conclusion: The hamstring autograft for an ACL reconstruction decreased the incidence of anterior kneeling pain and produced equivalent clinical results to the BPTB autograft.