A study on functional outcome of arthroscopic anatomical reconstruction of anterior cruciate ligament using quadrupled hamstring graft
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20172886Keywords:
Anterior cruciate ligament, Arthroscopic anatomical reconstruction, Biointerference screwAbstract
Background: Various techniques and graft types are now available for the reconstruction of ACL. Opinions differ among experts with regard to the ideal technique and graft type to be used. Arthroscopic anatomical ACL reconstruction using quadrupled hamstring autograft with fixation in the femoral tunnel using tightrope and in the tibial tunnel with interference screw is a relatively new technique. Purpose of this study is to analyze the postoperative outcome in our experience with this procedure.
Methods: This was a prospective study of patients with ACL injury who underwent Arthroscopic anatomical ACL reconstruction using quadrupled hamstrings autograft. All patients were operated upon by the same surgeon and had the same rehabilitation protocol. They were followed up for six months at regular intervals using IKDC, LGS scoring systems, tegner activity scale and a subjective questionnaire.
Results: About 95% of the patients had a favorable outcome as per three scoring systems. (IKDC, Lysholm score, subjective questionnaire) all three scoring system had a very high correlation around 90% of individuals were able to return to their pre injury activity level.
Conclusions: We conclude that the functional outcome of arthroscopic anatomical anterior cruciate ligament reconstruction using quadrupled hamstrings tendon autograft is excellent to good (95%). With proper patient selection and rehabilitation full occupational and recreational activities can be expected for most of the patients within four to six months of the procedure.
References
Moore KL. The Knee Joint In: Clinically oriented anatomy. 2nd ed. Williams & Wilkins 1985: 523-541.
Corner EM. The exploration of the knee joint: with some illustrative cases. Br J Surg 1914;2:191–204.
Hey-Groves EW. The crucial ligaments of the knee joint: Their function, rupture and the operative treatment of the same. Br J surg. 1920;7:505–15.
Smith A. The diagnosis and treatment of injuries of crucial ligaments. Br J Surg. 1918;6:176–89.
Strobel MJ. Anterior cruciate ligament. In: Textbook of manual of arthroscopic surgery. 1st ed. Heidelberg Berlin; Springer-Verlag; 1998: 67-9.
Khan RM, Prasad V, Gangone R, Kinmont JC. Anterior Cruciate Ligament Reconstruction in patients over 40yrs Using Hamstring Autograft. Knee Surg Sports Traumatol Arthroscopy. 2010;18(1):68-72.
Ristanis S, Giakas G, Papageorgiou CD, Moraiti T, Stergiou N, Georgoulis AD. The effects ofanterior cruciate ligament reconstruction on tibial rotation during pivoting after descending stairs. Knee Surg Sports Traumatol Arthrosc. 2003;11:360-5.
Georgoulis AD, Ristanis S, Chouliaras V, Moraiti C, Stergiou N. Tibial rotation is not restored after ACL reconstruction with a hamstring graft. Clin Orthop Relat Res. 2007;454:89-94.
Tashman S, Collon D, Anderson K, Kolowich P, Anderst W. Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med. 2004;32:975-83.
Kato Y, Maeyama A, Lertwanich P, Wang JH, Ingham SJ, Kramer S, et al Biomechanical comparisons of different graft positions for single bundle anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2013;21:816–23.
Fareed H, Dionellis P, Paterson FW. Arthroscopic ACL Reconstruction using 4 strand hamstring tendon graft. J Bone Join Surg. 2003;85:231-6.
Button K, Deursen RV, Price P. Management of functional recovery in individuals with acute anterior cruciate ligament rupture. Br J Sports Med 2005;39:866-71.
Reid A, Birmingham TB, Stratford PW, Alcock GK, Giffin JR. Hop testing provides a reliable and valid outcome measure during rehabilitation after anterior cruciate ligament reconstruction. Physical therapy. 2007;87(3):337.
Gulick TD, Yoder HN. Anterior cruciate ligament reconstruction: Clinical outcomes of patella tendon and hamstring tendon grafts. J Sports Sci Med. 2002;1:63-71.
