Arthroscopic reconstruction of anterior cruciate ligament: 4-strand versus 5-strand hamstring autograft

Abstract

INTRODUCTION: In present study, we aimed to compare the functional outcome after 4-strand versus 5-strand hamstring autograft for anterior crucial ligament reconstruction using Tegner Lysholm score. MATERIALS AND METHODS: Study included 70 cases (35 in each group) of complete anterior cruciate ligament tear confirmed radiologically on MRI. After doing anterior cruciate ligament reconstruction with 4- and 5-strand hamstrings autograft, the patients were assessed for the functional outcome using Tegner Lysholm score at post-operative interval of 3, 6 and 9 months. Data were analyzed using SPSS software version 21. RESULTS: Tegner Lysholm score at baseline was 41.63 and 42.01 in 4- and 5-strand group which increased progressively to 93.45 and 85.13 at the end of 9 months. The improvement was significantly more in 5-strand group (P < 0.05). Overall, at the end of follow-up, excellent results were seen in 71.4% versus 60% patients while good to fair results were seen in 20% versus 28.6% and 8.6% versus 8.6% patients in 4- and 5-strand groups, respectively. Poor outcome in terms of revision surgery was required in one case (2.9%) of 4-strand group. CONCLUSION: Study concluded that single 5-strand graft offers good functional outcome in cases of anterior crucial ligament reconstruction. A 5-strand hamstring graft provides an increase in diameter than 4-strand graft, which leads to stronger graft and reduced revision rate. It is especially useful in the cases of undersized hamstring graft or stability issues.