one leg hop test, Lysholm score, Tegner activity levelscore, IKDC or Patellofemoral pain score except betterkneeling ability and knee walking ability in the STgroup. Discomfort from loss of skin sensation was alsogreater in the BTB group. Regarding quality of life andknee function there were no significant differences inSF-36 or KOOS between the groups, however bothgroups were affected by their previous injury. Patientswho were reconstructed within 5 months from the injuryshowed significantly better activity level score regardlesschoice of graft.Discussion: The ST graft choice was still at 8 yearsfollowing reconstruction superior to BTB in terms ofkneeling ability, knee walking and discomfort from lossof skin sensation. Conventional knee scores, laxity andhop test revealed no differences, nor did quality of liferelated health assessment.Level of Evidence: 1

Paper 289: Long Term Results of ACL Reconstruc-tion with Bone Patella Bone Autograph: 23 YearFollow-up VONDA WRIGHT, MD, USA, PRESENTING AUTHOR

RUSSELL F WARREN, MD, USATHOMAS L. WICKIEWICZ, MD, USAHELENE PAVLOV, MD, USAROBERT G MARX, MD MSC FRCSC, USA

ABSTRACTIntro: Follow-up of patients with ACL using bone-pa-tella-bone auto graft was performed after a minimum of20 years.Methods: 105 patients underwent reconstruction usingBTB autograph between 1980-87. 31 were available forfollow-up after using social security searches and clinicalrecords. Functional and radiographic evaluation was per-formed.Results: Mean follow-up was 23.5 years. Mean KOOSsymptom score � 77.4, pain � 80.3, ADL � 91.83,sports� 72.59 and quality of life � 63.42 out of 100.ARS subjective rating of running, cutting, decelerationand pivoting averaged 5.38/16. Subjective IKDC indexwas 29.31/100 largely because they did not participate inthe kinds of activities questioned. IKDC ligament eval-uation showed 27.7% type A, 55.5% type B, 16.6% typeC and 0% type D. Patients had KT-1000 side-to-sidedifferences of �3mm in 76.9%, 3-6mm in 23.1%. X-rays(Kellgren-Lawrence OA of the worst compartment)showed 10% grade 0, 30% grade 1, 25% grade 2, 30%grade 3 and 5% grade 4. The Brandt scale quantified jointspace narrowing;75% had less than 25% narrowing and25% had �50% loss of space.

Discussion: Twenty-three years following ACL recon-struction patients retained good functional and radio-graphic outcomes. Patients were subjectively highfunctioning but had difficulty with sports skills. Ob-jectively 86.6% exhibited near normal ligamentous examsby IKDC and the majority had �3mm side-to-side differ-ences by KT-1000. Minimal joint changes were seen in65% with nearly normal joint preservation in �75%. Lo-cation of patients was a challenge and many patients werenot findable limiting the ability to interpret results widely.

Paper 290: Infrapatellar Branch of Saphenous NerveInjury During Hamstring Graft Harvest: A Prospec-tive Comparative Study of Three Different IncisionsDHANANJAYA SABAT, MS, INDIA, PRESENTING AUTHOR

VINOD KUMAR, MS, DNB, MNAMS, INDIA

ABSTRACTKey Words: ACL - hamstring graft.harvest – infrapa-tellar branch of saphenous nerveAim of the Study: To compare the incidence of injuryto infrapatellar branch of saphenous nerve (IPBSN) be-tween three different incisions of hamstrings graft har-vesting for ACL reconstruction.Introduction: Anatomical studies have identified safezones for making incisions to minimize injury to IPBSNwhile harvesting medial hamstrings graft. But clinicalcomparative studies are lacking to prove the advantageof a ny particular incision.Study Design: Prospective Cohort study.Material, Methods and Results: 92 patients who un-derwent ACL reconstruction with hamstrings graftwere prospectively studied. Group 1 consisted of 30patients with hamstrings graft harvested through stan-dard vertical incisions. There were 27 patients ingroup 2, in whom the graft was harvested by a trans-verse incision and 35 patients in group 3, in whom thegraft was harvested by anatomical oblique incision.The transverse incision was made between the ana-tomical landmarks for the superior and inferior trunksof IPBSN. The patients were reviewed at 6 weeks, 3months and 6 months and the area of skin numbnessaround the knee was mapped. Digital photographs ofthe area were taken and analyzed with Adobe photo-shop software. The results were analyzed with re-peated measures ANOVA.

There was significantly less incidence of cutaneoussensory loss in the distribution of IPBSN in patients withoblique followed by transverse incision. These group ofpatients also had higher subjective satisfaction scores forscar appearance.

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