Analysis of functional outcome of anterior cruciate ligament reconstruction using quadruple hamstring graft

Authors

  • Lalith Mohan Chodavarapu Department of Orthopedics, Nizam’s Institute of Medical Sciences, Hyderabad, India
  • Asif Hussain K. S. Department of Orthopedics, Nizam’s Institute of Medical Sciences, Hyderabad, India
  • K. K. Kiran Kumar Department of Orthopedics, Nizam’s Institute of Medical Sciences, Hyderabad, India
  • Chandrasekhar Patnala Department of Orthopedics, Nizam’s Institute of Medical Sciences, Hyderabad, India
  • Harikrishna Yadoji Department of Orthopedics, Nizam’s Institute of Medical Sciences, Hyderabad, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20172872

Keywords:

IKDC score, Transtibial technique, Quadruple hamstrings

Abstract

Background: Anterior cruciate ligament reconstruction is the most commonly reconstructed ligaments of the knee. This study attempts to analyse the functional outcome of ACL reconstruction and the parameters utilized commonly to assess the outcomes.

Methods: This is an analysis of 25 patients who underwent ACL reconstruction, who were operated by a single surgeon, and were studied for a period of one year .Analysis was made using standard scoring systems like Lysholm and IKDC score by an independent observer over a period of one year.

Results: The injury was commonly noted in the male gender although the sidedness of the injury did not seem to influence the outcome. The larger percentage of cases was operated less than 6 months from the date of injury. The mean graft diameter was 7.9 mm, with a positive correlation to the thickness of the thigh. The preoperative mean Lysholm score of 58.76 improved to 91.16 after surgery. The mean preoperative IKDC score improved from 29.26 to 58.70. One patient had infection and two had stiffness and reduced range of motion. The timing of surgery and rehabilitation influence the outcome largely.

Conclusions: Anterior cruciate ligament reconstruction surgery with quadrupled hamstring grafts provides a good outcome to ACL injuries when the surgery is timed well, with sufficient graft thickness and good rehabilitation.

Author Biography

Asif Hussain K. S., Department of Orthopedics, Nizam’s Institute of Medical Sciences, Hyderabad, India

Assistant Professor,

Department Of Orthopedics,

Nizam's Institute Of Medical Sciences,

Hyderabad-500082

References

Meighan AA, Keating JF, Will E. Outcome after reconstruction of the anterior cruciate ligament in athletic patients. A comparison of early versus delayed surgery. J Bone Joint Surg Br. 2003;85:521-4.

Milankov M, Obradović M, Vranješ M, Budinski Z. Bone-patellar tendon-bone graft preparation technique to increase cross-sectional area of the graft in anterior cruciate ligament reconstruction. Med Pregl. 2015;68(11-12):371-5.

Brown CH, Sklar JH. Endoscopic anterior cruciate ligament reconstruction using quadrupled hamstring tendons and endo button femoral fixation. Techniques in orthopaedics. 1998;13(3):298.

Tuman JM, Diduch DR, Rubino LJ, Baumfeld JA, Nguyen HS, Hart JM. Predictors for hamstring graft diameter in anterior cruciate ligament re-construction. Am J Sports Med. 1949;35(11):1945–9.

Brown TN, Palmeri-Smith RM, Mc Lean SG. Sex and limb differences in hip and knee kinematics and kinetics during anticipated and unanticipated jump landings: implications for anterior cruciate ligament injury. British J Sports Med. 2009;43:1049-56

Nikolaou VS, Chronopoulus E, Savvidaou. MRI efficacy in diagnosing internal lesions of the knee :A Retrospective Analysis. J Trauma Manag Outcomes. 2008;2(1):4.

Shelbourne KD, Wilcken JH, Mollabashy A, DeCarlo M. Arthrofibrosis in acute anterior cruciate ligament reconstruction. The effect of timing of reconstruction and rehabilitation. Am J Sports Med. 1991;19(4):332‐6.

Shelbourne KD, Patel DV. Timing of surgery in anterior cruciate ligament‐injured knees. Knee Surg Sports Traumatol Arthrosc. 1995;3(3):148‐56.

Almekinders LC, Moore T, Freedman D, Taft TN. Post‐operative problems following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 1995;3(2):78‐82.

Treme G, Diduch DR, Billante MJ, Miller MD, Hart JM. Hamstring graft size prediction: a prospective clinical evaluation. Am J Sports Med. 2008;36(11):2004-9.

Kocher MS, Richard Steadman J, Briggs KK, Sterett WI, Hawkins RJ. Relationships Between Objective Assessment of Ligament Stability and Subjective Assessment of Symptoms and Function After Anterior Cruciate Ligament Reconstruction. Am J Sports Med. 2004;32(3):629-34.

Williams III RJ, Hyman J, Petrigalino F, Rozental T, Wickiewicz TL. Anterior ligament reconstruction with a four strand quadruple hamstring tendon autograft. J Bone Joint Surg. 2004;86:225-32.

Collins N, Misra D, Felson D, Crossley K, Roos E. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care Res (Hoboken). 2011;63(11):208–28.

Downloads

Published

2017-06-23

Issue

Section

Original Research Articles