Outcome analysis following arthroscopic augmentation with autologous hamstring graft in partial tear of the anterior cruciate ligament with preservation of an intact bundle: A case series

Abstract

Background: The anatomic approach to anterior cruciate ligament (ACL) reconstruction has shifted management focus of the commonly encountered partial tear from resection and complete reconstruction to augmentation (i.e. selective bundle reconstruction with preservation of intact remnant bundle). The purpose of this study was to prospectively evaluate functional outcome after augmentation of partial ACL tears. Methods: Thirty-four patients with a partial ACL tear in whom a conservative trial failed were treated with either anteromedial or posteromedial single-bundle reconstruction, using an isolated semitendinosus graft and conserving the remnant bundle. Outcomes were evaluated clinically using the 2000 International Knee Documentation Committee [IKDC] knee examination forms, and manual laxity tests. Subjective evaluation was done using the 2000 IKDC subjective knee evaluation, Lysholm knee score, and 2000 IKDC functional score. Patient activity level was determined using the Tegner activity score. IKDC knee grades were assigned based on final evaluation on the 2000 IKDC knee examination forms. Results: At final follow-up 2000 IKDC knee examination grades significantly improved, with 21 in group B (61.8%) and 12 in group A (35.3%), while preoperatively most were classified as group C (76.5%). Similarly, IKDC subjective and Lysholm scores were significantly better after follow-up. The difference between mean Tegner activity level preinjury (6.029±0.9040) and at follow-up (5.67±1.006) was not significant. Conclusions: Selective bundle reconstruction with preservation of remnants restores knee stability and function. The results are encouraging, with excellent improvement in functional scores. Level of Evidence: Level IV.