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Letter

Adelaide, South Australia

Dear Editor:

In the article entitled "Arthroscopic Reconstruction of the Anterior Cruciate Ligament. A Comparison of Patellar Tendon Autograft and Four-Strand Hamstring Tendon Autograft" (Corry et al., July/August 1999, pp 444–454), I wish to question apparent discrepancies between the abstract conclusions and the data contained in Table 5. In the abstract, the authors state, "These methods (including instrumented testing) revealed no difference between the groups in terms of ligament stability ..." They further state that "The KT-1000 arthrometer testing showed a slightly increased mean laxity in the female patients in the hamstring group."

However, Table 5 shows a significant difference (P = 0.02, t-test) in the overall KT-1000 arthrometer findings between the patellar tendon group (side-to-side difference, 1 mm) and the hamstring tendon group (1.7 mm). Also, the difference for women was certainly more than "slight" (patellar tendon, 1 mm, versus hamstring, 2.5 mm). The Table 5 data also report only the 89-Newton results, and these differences can be expected to increase markedly with the maximum manual data from the KT-1000 arthrometer tests. Why are these results not reported?

Author’s Response

Crows Nest, Australia

The term "ligament stability" refers to clinical findings, whereas "laxity" in this context refers to instrumented testing by the KT-1000 arthrometer. In terms of clinical or functional stability, the significance of small changes in KT-1000 arthrometer values is unknown. As stated in the article, the KT-1000 arthrometer values correlated very poorly with activity level, International Knee Documentation Committee (IKDC), or Lysholm scores. With respect to the attainment of sporting levels, the mean KT-1000 arthrometer value for level 1 was 1.2 mm, for level 2 it was 1.8 mm, for level 3 it was 1.2 mm, and for level 4 it was 1.3 mm.

The KT-1000 arthrometer finding at 89 N was the recommended IKDC test at the time that this study was commenced in 1992 and, unfortunately, KT manual maximum data were incomplete. There is no reliable evidence that KT manual maximum testing is any better or any worse than the KT-1000 arthrometer at 89 N. In the 5-year comparison of these patients, which is currently being prepared, we will report the KT manual maximum values.

This Article Full Text (PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Keene, G. Articles by Pinczewski, L. Search for Related Content PubMed PubMed Citation Articles by Keene, G. Articles by Pinczewski, L.