DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20195634

Quality of life and thigh girth following anterior cruciate ligament reconstruction using hamstring autograft

Mirza A. Baig

Abstract


Background: Arthroscopic anterior cruciate ligament reconstruction is commonly performed with intent to return earlier to normal activities, so graft selection becomes more important. The use of hamstring tendon autograft is supposed to have less postoperative morbidities. In this prospective study we assess the early post-operative complications.

Methods: 25 patients were operated in Shadan Institute of Medical Sciences and Research Centre, Hyderabad, India, by the same surgeon and were assessed preoperatively, and 3 and 6 months after surgery. The hamstring and quadriceps strength were measured with PRIMUS RS machine. The patients were also assessed for their subjective complaints using International Knee Documentation Committee (IKDC) knee scoring system.

Results: The peak power of flexion and extension of the knee joint significantly improved following the surgery which is essential for any athletic activities. Quadriceps and hamstring strengths were restored to 90%, which suggests that the grafting has been successful in restoring isometric strength. This is necessary to return to sporting activities. Power of hamstrings and quadriceps significantly improved following surgery. Quadriceps and hamstring endurance recovered and improved at the end of 6 months following surgery. Using IKDC scoring, nearly normal were 14, normal were 10 and abnormal 1. 3 patients (12%) presented with anterior knee pain. Sensory loss was noted in 6 patients (24%) at the end of 6 months following surgery. Swelling was noted in 5 patients (25%).

Conclusions: Most morbidities are temporary in nature and do not significantly affect the patient’s activities.


Keywords


Anterior cruciate ligament, Hamstring, Semitendinosis gracilis, Quadriceps, Torque, Peak power, endurance, H/Q ratio, Isokinetic, Isometric, Endobutton

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References


Corry IS, Webb JM, Clingeffer AJ, Pinczewski LA. Arthroscopic reconstruction of the anterior cruciate ligament. A comparison of patellar tendon autograft and four-strand hamstring tendon autograft. Am J Sports Med. 1999;27:444-54.

Azar FM, Arthur ST. Complications of anterior cruciate ligament reconstruction. Tech Knee Surg. 2004;3:238-50.

Mochizuki T, Akita K, Muneta T, Sato T. Anatomical bases for minimizing sensory disturbance after arthroscopically-assisted anterior cruciate ligament reconstruction using medial hamstring tendons. Surg Radiol Anat. 2003;25:192-9.

Feller JA, Webster A, Gavin B. Earlypost-operative morbidity following anterior cruciate ligament reconstruction: patellar tendon verses hamstring graft. Knee Surg Sports Traumatol Arthrosc. 2001;9:260-9.

Marder RA, Raskind JR, Carroll M. Prospective evaluation of arthroscopically assisted anterior cruciate ligament reconstruction. Patella tendon versus semitendinosus and gracilis tendons. Am J Sports Med. 1991;19:478-84.

Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;198:43-9.

Yunes M, Richmond JC, Engels EA, Pinczewski LA. Patellar versus hamstring tendons in anterior cruciate ligament reconstruction: a meta- analysis. Arthroscopy. 2001;17:248-57.

Yasuda K, Tsujino J, Ohkoshi Y, Tanabe Y, Kaneda K. Graft site morbidity with autogeneous semitendinosus and gracilis tendons. Am J Sports Med. 1995;23:706-14.

Spicer DD, Blagg SE, Unwin AJ, Allum RL. Anterior knee symptoms after four-strand hamstring tendon anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2000;8:286-9.

Dvir Z. Isocinetica: avaliaçoes musculares, interpretaçoes e aplicaçoes clinicas. Sao Paulo: Manole; 2002: 201.