Published: 2021-04-26

Arthroscopic anterior cruciate ligament reconstruction using single bundle hamstring tendon autograft

Harpreet Singh, Tilak Patel, Kamal Kumar Agarwal, Parth Patel, Dhruv Patel, Krushna Saoji


Background: The present study was designed to analyze the postoperative outcome of arthroscopic anterior cruciate ligament (ACL) reconstruction with anatomical single bundle hamstring tendons autograft fixed in femoral tunnel using endobutton and in the tibial tunnel using interference screws and reinforced by anterior half of peroneus longus tendon (AHPLT), wherever required.

Methods: 39 patients of complete ACL tear underwent arthroscopic anatomical single bundle ACL reconstruction using quadrupled hamstring tendon autograft. It was ensured that the quadrupled graft had a length of at least 7 cm and thickness of at least 8 mm. If either of these requirements were not met, then the graft was supplemented by AHPLT. For functional assessment, international knee documentation committee (IKDC) knee score was taken and clinical tests for antero-posterior stability were done. In addition, the foot and ankle disability index (FADI) scores were used to evaluate the ankle donor site of the AHPLT.

Results: The average graft diameter was 8.74 mm and average graft length was 9.12 cm. There was significant improvement in post op IKDC score when compared with pre op score. There was no antero-posterior instability seen in any of the patients during follow up. 10 patients required an additional graft augmentation with AHPLT. There was no complaint about weakness of the ankle joint after surgery.

Conclusions: Arthroscopic ACL reconstruction with anatomical single bundle hamstring tendon autograft is an excellent treatment option for ACL deficient knees. It gives excellent functional outcome with minimal complications. Graft if small in diameter can be reinforced by AHPLT without any detrimental effect on ankle function.


ACL, Hamstring tendon graft, AHPLT, Anatomical single bundle, IKDC score

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