Introduction: Hamstring tendon (HT) and bone patellar tendon bone (BPTB) are the commonly used
autograft in an anterior cruciate ligament reconstruction surgery. The BPTB is said to have more incidence of
anterior knee pain compared to HT. The study aimed to compare the severity of knee pain during Islamic
prayer kneeling. Methods: A cross sectional cohort analysis of patients undergoing ACL reconstruction surgery
using BPTB with HT autografts was conducted to determine differences in postoperative pain while kneeling
and ability to pray in normal position. Kneeling during prayer and the ability to sit while performing prayer
were assessed at 3rd, 4th, 5th and 6th month. Results: There were no significant differences in mean pain score
while kneeling at 3rd, 4th, 5th and 6th month. The mean difference of patient’s ability to perform normal
prayers for BPTB (3.56+1.16) and HT (3.30+1.05) was found insignificant. The average number of patients in
both groups was able to pray between 3 to 4 months post operatively as full range of motion of knee is
allowed within this period. Total 49 patients (BPTB 23, HT 26) out of 60 were able to pray normally within 4
months post-operation. Mostly delayed due to anterior knee pain. Conclusion: There is no different in term of
knee pain during kneeling while performing Islamic prayer between those who had their ACL reconstructed
either using BPTB or HT autograft.