Clinical Outcome of Anatomical Transportal Arthroscopic Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autograft

Abstract

Background: Good clinical outcome and return to sport and daily functions after anatomical arthroscopic anterior<br />cruciate ligament (ACL) reconstruction is goal standard in this surgery. but to date, there are different challenging<br />issues between orthopedic surgeons regarding graft selection and surgical techniques.<br />Methods: We retrospectively reviewed the patients who underwent anatomical arthroscopic one bundle ACL<br />reconstruction with quadruple hamstring tendon autograft from 2010 to 2016 in our orthopedic sport medicine center.<br />Eighty-two eligible patients (82 knees) who had met our inclusion criteria were examined in terms of knee stability by<br />clinical examinations and KT 2000 arthrometer and - also were evaluated regarding variables related to their health<br />and knee status with a mean 48months follow-up.<br />Results: Seventy-seven patients (93.9%) were male and the other 5 cases (6.1%) were female. The mean age<br />was 33 ± 8.06 years old at the time of surgery and mean BMI amount was 26.81 ± 3.72. 78 patients (95%) returned<br />to pre-injury sport activity level after ACL reconstruction and two patients (2.4%) had re-rupture. 63 patients<br />(76.8%) had negative anterior drawer and 67patients (81.8%) negative lachman tests respectively. 10 patients<br />(13%) were found to have positive pivot shift tests which was correlated with pain and a less KOOS scores with a<br />significant difference (P= 0.03). 72 patients (87%) had negative tests in active and 70 (85.4%) had less than 3 mm<br />side to side difference in manual testing by KT2000. Final KOOS score was 70.87 ± 19.76. Mean Lysholm score<br />was 90 ± 4.77. Mean International Knee Documentation Committee (IKDC) score of this study was 85 ± 14.11.<br />Patients who had concomitant partial meniscectomy had significantly lower IKDC scores (P<0.01).Mean kujala<br />score was 79 ± 3.07.<br />Conclusion: The use of quadrupled hamstring tendon autograft besides the most important part of the treatment<br />which is the surgical technique would yield to excellent results in ACL reconstruction both subjectively and objectively.<br />In addition, patient selection and surgeon's experience should be considered in determining the treatment plan for the<br />patients.