在以不同移植物手術的兩組病人都滿意於手術結果，而臨床結果顯示 兩種移植物在 Lysholm 量表，anterior drawer test 及 Lachman test 的結果均沒有差別，因此在這個研究我們並不能決定那種肌腱移植優 於另一種。但是實驗結果發現肌力的缺損和使用的自體移植肌腱的類 型有關,而起因是由於捐贈區病變（donor site morbidity）引起。
雖然有些作者認為股四頭肌及腿後肌肌肉的力量會隨時間的經過恢 復正常，但需要花多少時間來恢復卻沒有共識，這次研究的顯示肌力 的缺損在前十字韌帶重建術後長期追蹤時並沒有恢復正常，而這結果 和其他作者的結果相似。十字韌帶重建術後的肌力減弱就會影響患者 運動上的表現和生物力學步態的改變，長期步態改變將會促使退化性 關節炎產生。
我們的結論是在以自體腿後肌腱移植的病人在膝關節彎曲時腿後肌 的肌力缺損、及以自體髕骨肌腱移植的病人在膝關節伸展時股四頭肌 的肌力缺損持續的時間比預期還久。
參考文獻
1. Feller JA, Webster KE. A randomized comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction. Am J Sports Med 2003;31:564-573.
2. Ristanis S, Stergious N, Patras K et al. Follow-up evaluation 2 years after ACL reconstruction with bone-patellar tendon-bone graft shows that excessive tibial rotation persistes. Clin J Sport Med 2006;16:111-116.
3. Carter TR, Edinger S. Isokinetic evaluation of anterior cruciate ligament
reconstruction: hamstring versus patellar tendon. Arthroscopy 1999;15:169-172.
4. Anne AK, Holm I, Risberg MA, Jensen HK, Steen H. Four-strand hamstring tendon autograft compared with patellar tendon-bone autograft for anterior cruciate ligament reconstruction. Am J Sports Med 2001;29:722-728.
5. Lysholm J, Gillquist J. Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 1982;10:150-154.
6. Corry IS, Webb JM, Cringeleffer AJ, et al. Arthroscopic reconstruction of the anterior cruciate ligament. A comparison of patellar tendon autograft and four –strand hamstring tendon autograft. Am J Sports Med 1999;27:444-454.
7. Risberg MA, Holm I, Steen H, Beynnon DM. Sensitivity to changes over time for the KKDC form, the Lysholm score, and the Cicinnati knee score. Knee Surg
Sports Traumatol Arthrosc 1999;7:152-159.
8. Aglietti P, Girfon F, Buzzi R, BIddan F, Sasso F. Anterior cruciate ligament reconstruction: bone-patellar-bone compared with double semi-tendinosus and gracilis tendon grafts. A prospective, randomized clinical trial. J Bone Joint Surg 2004;86A:2143-2155.
9. Forster MC, Foster IW. Patellar tendon or four-strand hamstring? A systemic review of autografts for anterior cruciate ligament reconstruction. Knee 2005;12:225-230.
10. Yunes M, Richmond JC, Engels EA, et al. Patellar versus hamstring tendons in anterior cruciate ligament reconstruction: a meta-analysis. Arthroscopy
2001;17:248-257.
11. Freedman KB, D’Amato MJ, Nedeff DD, et al. Arthroscopic anterior cruciate ligament reconstruction: a meta-analysis comparing patellar-tendon and hamstring tendon autografts. Am J Sports Med 2003;31:2-11.
12. Goldblatt JP, Fitzsimmons SZ, Balk E, Richmond JC. Reconstruction of the anterior cruciate ligament: meta-analysis of patellar tendon versus hamstring tendon autograft. Arthroscopy 2005;21:791-803.
13. Eriksson K, Anderberg P, Hamberg P et al. A comparison of quadruple
semitendinosus and patellar tendon grafts in reconstruction of the anterior cruciate
ligament. J Bone Joint Surg 2001;83B:348-354.
14. Sekiya I, Mangeta T, Ogiuchi T, et al. Significance of the single-legged hop test to the anterior cruciate ligament-reconstructed knee in relation to muscle strength and anterior laxity. Am J Sports Med 1998;26:384-388.
15. Carter TR, Zduger S. Isokinetic evaluation of anterior cruciate ligament
reconstruction: hamstring versus patellar tendon. Arthroscopy 1999;15:169-172.
16. Brandsson S. Thesis. Anterior cruciate ligament injury: results after reconstruction in terms of function, postoperative pain and kinematics. Dept of Orthopaedics, Institute of Surgical Sciences, Goteborg University, Goteborg, 2000:116-126.
17. Sachs RA, Daniel DM, Stone ML, et al. Patellofemoral problems after anterior cruciate ligament reconstruction. Am J Sports Med 1989;17:760-765.
18. Marken RA, Raskind JR, Carrol M. Prospective evaluation of arthroscopically assisted anterior cruciate ligament reconstruction. Am J Sports Med
1991;19:478-483.
19. Back BR. Jr, Jones GT, Sweet FA, et al. Arthroscopy-assisted anterior cruciate ligament reconstruction using patellar tendon substitution. Am J Sports Med 1994;22:758-767.
20. Saddemi SR, Frogameni AD, Fenton PJ. Comparison of perioperative morbidity of anterior cruciate ligament autografts versus allografts. Arthroscopy
1993;9:519-524.
21. Victor J, Bellemans J, Witvrouw E, Goraersk, Fabry G. Graft selection in anterior cruciate ligament reconstruction-prospective analysis of patellar tendon autografts compared with allografts. Int Orthop 1999;21:93-97.
22. Jong SW, Caspel DR, Haeff MJ, et al. Functional assessment and muscle strength before and after reconstruction of chronic anterior cruciate ligament lesions.
Arthroscopy 2007;23:21-29.
23. Lautamies R, Harilainen A, Kettunen J, Sandelin J, Kujala UM. Isokinetic
quadriceps and hamstring muscle strength and knee function 5 years after anterior cruciate ligament reconstruction: comparison between bone-patellar tendon-bone and hamstring tendon autografts. Knee Surg Sports Traumatol Arthrosc
2008;16:1009-1016.
24. Feller J, Webster K, Gavin B. Early post-operative morbidity following anterior cruciate ligament reconstruction: patellar tendon versus hamstring graft. Knee Surg Sports Traumatol Arthrosc 2001;9:260-266.
25. Wilk KE, Romaniello WT, Soscia SM, Anigo CA, Andrewd JR. The relationship between subjective knee scores, isokinetic testing and functional testing in the ACL-reconstructed knee. J Orthop Sports Phys Ther 1994;20:60-73.
26. Tashiro T, Kurosawa H, Kawakami A, Hikita A, Fukui N. Influence of medial
hamstring tendon harvest in knee flexor strength after anterior cruciate ligament reconstruction- a detailed evaluation with comparison of single-and double-tendon harvest. Am J Sports Med 2003;31:522-529.
27. Seto J, Orofino A, Morrisey M, Medeiros J, Mason W. Assessment of quadriceps/hamstring strength, knee ligament stability, functional and sports activity levels five years after anterior cruciate ligament reconstruction. Am J Sports Med 1988;16:170-180.
28. Markolf KC, Graff-Redford A, Amstutz HC. In vivo knee stability: a quantitative assessment using an instrumented clinical testing apparatus. J Bone Join Surg 1998;60A:664-674.
29. Engelhardt M, Renter I, Freiwald J. Alterations of the neuromuscular system after knee surgery. Eur J Sports Traum Rel Res 2001;23:75-81.
30. Simonian PT, Harrison SD, Cooley VJ, et al. Assessment of morbidity of semitendinosus and gracilis tendon harvest for ACL reconstruction. Am J Knee Surg 1997;10:54-59.
31. Makihara Y, Nishino A, Fukubayashi T, Kanamori A. Decrease of knee flexion torque in patients with ACL reconstruction: combined analysis of the architecture and function of the knee flexor muscles. Knee Surg Sports Traumatal Arthrosc 2006;14:310-317.
32. Erikkson K, Larsson H, Wredmark T, et al. Semitendinosus tendon regeneration after harvesting for ACL reconstruction. A prospective MRI study. Knee Surg Sports Traumatol Arthrosc 1999;7:220-225.
33. Akima H, Kaino S, Fukanaga T, et al. Architectural properties and specific tension of human knee extensor and flexor muscles based on magnetic resonance imaging.
Jpn J Phys Fitness Med 1998;44:267-278.
34. Papandrea P, Vulpiani MC, Ferrett A, et al. Regeneration of the semi-tendinosus tendon harvested for anterior cruciate ligament reconstruction. Evaluation using ultrasonography. Am J Sports Med 2000;28:556-561.
35. Sell TC, Ferris CM, Abt JP, et al. Predictors of proximal tibial anterior shear force during a vertical stop-jump. J Orthop Res 2007;25:1589-1597.
36. Withrow TJ, Huston LJ, Wojtys EM, et al. The relationship between quadriceps muscle forces knee flexion, and anterior cruciate ligament strain in an in vitro simulated jump landing. Am J Sports Med 2006;34:269-274.
37. Webster KE, Wittrer JZ, O’Brien J, Feller JA. Gait patterns after anterior cruciate ligament reconstruction are related to graft type. Am J Sports Med
2005;33:247-254.
38. Cappozzo A, Catani F, Learkoni A, Beneditti MG, Croce UD. Position and orientation in space of bones during movement: experimental artifacts. Clin
Biomech 1996;11:90-100.
39. Chambers HG, Sutherland DH. A practical guide to gait analysis. J Am Acad Orthop Surg 2002;10:222-231.
40. Lewek M, Rudolph K, Axe M. Syyder ML. The effect of insufficient quadriceps strength on gait after anterior cruciate ligament reconstruction. Clin Biomech 2002;17:56-63.
41. Mittlmeier T, Weier A, Sohn T, Kleinhans L, et al. Functional monitoring during rehabilitation following anterior cruciate ligament reconstruction. Clin Biomech
1999;14:576-584.
Morrow JR, Jackson AW. How ”significant” is your reliability? Res Q Exers Sport 1993;64:352-355.