A STUDY OF FUNCTIONAL OUTCOME OF ACL RECONSTRUCTION WITH ANATOMICAL HAMSTRING TENDON AUTOGRAFT

Abstract

Background: The Anterior Cruciate ligament (ACL) is the primary stabilizer of the knee and prevents the knee against anterior translation. It is also important in counteracting rotational and valgus stress. Anterior Cruciate Ligament (ACL) reconstruction is an established and widely practiced surgical procedure with proven efcacy and a low morbidity prole. The arthroscopically aided approach has the advantages of smaller skin and capsular incisions, improved viewing of the intercondylar notch for placement of the tunnel and attachment sites, less postoperative pain, fewer adhesions, earlier motion, and easier rehabilitation. The advantages with anatomical hamstring grafts are availability of a greater sectional area and unaffected integrity of the extensor mechanism. Moreover tensile strength of quadrupled anatomical hamstring is found to be even better than a normal ACL. The rate of complications like extension loss, anterior knee pain and surgical site infections was also lower than other procedures. Cortical suspension devices have the necessary biomechanical properties with regard to ultimate failure strength, displacement, and stiffness for initial xation of soft tissue in the femoral tunnel for ACL reconstruction. The aperture xation methods like the interference screws allows for early rm xation and heal with tight bone-tendon interface. To evalua Objectives: te functional outcome of arthroscopy assisted ACL reconstruction with anatomical hamstring tendon graft using Endobutton and Bioabsorbable interference screw and tibial disc. The Methodology: study results included 30 patients admitted with clinical and radiological deciency of ACL during October 2021 to December 2022, in Department of Orthopaedics, SMIMER Hospital, Surat. Study aims to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction with anatomical hamstring tendon graft using Endobutton and Bioabsorbable interference screw and tibial disc in terms of range of motion, postoperative knee stability, graft site morbidity, subjective knee functions and prospective assessment of functional outcome using Tegner Lysholm knee scoring system. All the patients included in the s Results: tudy were 23 male and 2 female patient. The analysis of the studied cases revealed that the most common affected age group was between 18 to 24 years .. Majority of patients were operated more than 6 months after injury. Sports/BPET (Battle Physical Efciency Test) injuries was the most common mode of injury. The mean size of graft used was 8.2±0.39.Post-operatively at 3, 6, 12month follow up,1 case (4%) had a positive Pivot shift test with a "Glide" (Grade-I), whereas remaining 24 cases (96%) had a negative Pivot shift test. None of the patients had grade III laxity. The mean postoperative Lysholm score improved from preoperative score of 66±5.2 to 88.70±5.54. The overall satisfactory result (excellent + good) at follow up was 95%. All the patients had returned to preinjury level of activity. ACL injuries are common in younger age group individuals. S Conclusion: ports related injury and RTA are the most common modes of injury. Arthroscopy assisted ACL reconstruction using Anatomical hamstring tendon autograft provides a stable knee, reduces postoperative morbidity and enables early rehabilitation. Graft xation using endobutton and and Bioabsorbable interference screw will help the graft to facilitate graft tunnel healing and also maintain its strength until there is a good graft to bone healing occurs. It allows the patients to return to preinjury level of activity, allows the patient to squat, sit crossed leg and climb stairs without difculty. Degeneration of the articular surfaces rarely occurs and the re-operation rates are minimal.