Evaluation of Long-Term Outcome of Arthroscopic Reconstruction of Isolated Anterior Cruciate Ligament Injury by Hamstring Quadrupled Auto Graft Fixed by Bio Screws in a Tertiary Level Hospital

Abstract

Background: Hamstring tendon auto grafts in the form of tripled or quadrupled semitendinosus and gracilis (STG) has become useful alternative for anterior cruciate ligament (ACL) reconstruction. Bio screw avoids complications by decreasing possibility of graft damage. Current study was designed to evaluate arthroscopic ACL reconstruction with quadrupled semitendinosus auto graft and fixation of the graft by two biodegradable screws in both femur and tibia. Objectives: This study was conducted to evaluate the long term outcome of arthroscopic reconstruction of injured ACL by quadrupled semitendinosus tendon auto graft using biodegradable screws for both tibia and femur. Methods: 300 patients with isolated ACL injury admitted from January 2010 to December 2015 in Apollo Hospitals Dhaka were enrolled. All patients underwent arthroscopic ACL reconstruction surgery by Hamstring quadrupled auto graft fixed by Bio Screws. After discharge, these patients were followed up for 3 weeks, 3 months and final outcome was recorded after 6 years. Results: 270 patients (90%) had uneventful post-operative period. 20 patients (6.67%) complained post-operative pain after 3 weeks, 10 patients (3.33%) complained of knee swelling ,7 (2.33%) patients had infections & 24 patients (8%) had knee stiffness after 6 months. Post operatively, Lachman test improved significantly, grade 0 in 94.33% cases (283 patients) and grade I was in 5.67% cases (17 patients). Anterior drawer test was also markedly improved. Grade 0 in 96.33% cases (290 patients) and grade I was in 3.67% cases (10 patient). According to the Lysholm Knee Scoring, the final long term outcome was excellent in 76.67% cases (230 patients), good in 20% cases (60 patients) and fair in 3.33% cases (10 patients). Conclusion: Arthroscopic reconstruction of ACL by quadrupled hamstring autograft fixed by biodegradable screws for both tibia and femur, leads good to excellent results in majority of the cases.