Arthroscopic Anterior Cruciate Ligament Reconstruction Using Four-Strand Hamstring Graft – A Prospective Medium Term Study

Abstract

In this study, we analyzed the clinical outcomes at two years following reconstruction of the anterior cruciate ligament with use of a four-strand hamstring tendon autograft in patients who had presented with a symptomatic torn anterior cruciate ligament. Twenty four consecutive patients who had an isolated, symptomatic anterior tibial subluxation associated with rupture of the anterior cruciate ligament were treated with reconstruction of the anterior cruciate ligament with a four-strand autologous semitendinosus-gracilis tendon graft. One surgeon performed all of the operations. Prior to surgery and at the follow-up examination, physical findings and functional scores were recorded and knee radiographs were analyzed. Following surgery, a six-month rehabilitation regimen was implemented. Of the 41 patients operated 24 were available for follow-up. Twenty three of the patients had stable pain free knee negative Lachman and pivot shift tests. The mean IKDC score improved from an average preoperative from 38.62 point to average at final follow up 89.11 points at the time of follow-up (p < 0.01). One patient (5.5%) had a positive Lachmann's test at final follow up. One patient had a traumatic rupture of the graft, occurring at a 16 months postoperatively. Reconstruction of the anterior cruciate ligament with use of a four-strand hamstring tendon autograft eliminated anterior tibial subluxation in 94.5% of patients who were examined at a minimum of two years postoperatively. The functional knee scores were significantly increased at the time of follow-up. A prospective study of 24 patients of Arthroscopic ACL reconstruction, all operated on by a Single Surgeon followed up for 24 months. All the patients were operated between January and December 2005. Of the 41 patients operated, 24 were available for regular followup till 2 years. The study assessed the Clinical outcome at various intervals during the study period.