.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.jpg)
Functional Outcome of Arthroscopic Single Bundle Anterior Cruciate Ligament Reconstruction (ACLR) using Hamstring Auto Graft
Keywords:
Anterior Cruciate Ligament, Arthroscopy, Auto Graft, Hamstring, IKDC.Abstract
Objective: To determine the functional outcome of arthroscopic single-bundle Anterior Cruciate Ligament Reconstruction (ACLR ) using Hamstring auto graft in patients with complete Anterior Cruciate Ligament (ACL) rupture.
Methods: This descriptive study was conducted in Liaquat National Hospital, Karachi from 20th March 2016 to 20th March 2021.All adults patients with ACL tear fulfilling the inclusion criteria were treated arthroscopically with single bundle ACLR using Hamstring auto graft. Functional outcome at two years were assessed with International Knee Documentation Committee (IKDC) scoring system and compared with pre operative value. P value was calculated with Chi-square test and Independent Sample-t test. P value <0.05 was considered significant
Results: We performed 136 single bundle arthroscopic ACLR using Hamstring auto graft. The mean age of our patients were 33.28±10.22 years. Male patients were 128(94.11%) and female patients were 8(5.88%). Right sided ACLR was performed in 88(64.70%) patients and left sided in 48(35.29%) patients. The mean pre-operative IKDC score was 43.45 ±10.68 and improved to 89.87±13.40 at two years follow up.(p<0.05).
Conclusion: Excellent functional outcome was achieved with arthroscopic single bundle Hamstring ACLR in majority of our patients. We recommend Single bundle arthroscopic Hamstring ACLR as technique of first choice in patients with ACL rupture.
References
Myklebust G, Bahr R. Return to play guidelines after anterior cruciate ligament surgery. Br J Sports Med. 2005;39(3):127-131.
Orchard J, Seward H. Epidemiology of injuries in the Australian Football League, seasons 1997-2000. Br J Sports Med. 2002;36(1):39-44.
Jagtap V, Gorgile N, Shah Y, Rokade V, Bartakke G. Functional outcome of an arthroscopic anatomical single bundle anterior cruciate ligament reconstruction using semi-tendinosus graft with fixation using endo-button on femoral side and suture disc on tibial side: a prospective clinical study. Int J Res Orthop. 2017;3(6):1175-1179.
Frank CB, Jackson DW. The science of reconstruction of the anterior cruciate ligament. J Bone Joint Surg Am. 1997;79(10):1556-1576.
Groves EW. The classic Operation for repair of the crucial ligaments. Clin Orthop Relat Res. 1980 ;(147):4-6.
Bertoia JT, Urovitz EP, Richards RR, Gross AE. Anterior cruciate reconstruction using the MacIntosh lateral-substitution over-the-top repair. J Bone Joint Surg Am. 1985;67(8):1183-1188.
Eriksson E. Reconstruction of the anterior cruciate ligament. Orthop Clin North Am. 1976;7(1):167-179.
Lipscomb AB, Johnston RK, Snyder RB, Warburton MJ, Gilbert PP. Evaluation of hamstring strength following use of semitendinosus and gracilis tendons to reconstruct the anterior cruciate ligament. Am J Sports Med.1982;10(6):340-342.
Martin SD, Martin TL, Brown CH. Anterior cruciate ligament graft fixation. Orthop Clin North Am. 2002;33(4):685-696.
Fu FH, van Eck CF, Tashman S, Irrgang JJ, Moreland MS. Anatomic anterior cruciate ligament reconstruction: a changing paradigm. Knee Surg Sports Traumatol Arthrosc. 2015;23(3):640-648.
Sadoghi P, Kropfl A, Jansson V, Müller PE, Pietschmann MF, Fischmeister MF. Impact of tibial and femoral tunnel position on clinical results after anterior cruciate ligament reconstruction. Arthroscopy. 2011;27(3):355-364.
Xu H, Zhang C, Zhang Q, Du T, Ding M, Wang Y, et al. A Systematic Review of Anterior Cruciate Ligament Femoral Footprint Location Evaluated by Quadrant Method for Single-Bundle and Double-Bundle Anatomic Reconstruction. Arthroscopy. 2016 ;32(8):1724-1734.
An VV, Scholes C, Mhaskar VA, Hadden WJ, Parker D. Limitations in predicting outcome following primary ACL reconstruction with single-bundle hamstring autograft - A systematic review. Knee. 2017;24(2):170-178.
Irrgang JJ, Anderson AF, Boland AL, Harner CD, Kurosaka M, Neyret P, et al. Development and validation of the international knee documentation committee subjective knee form. Am J Sports Med. 2001;29(5):600-13.
Malempati CS, Metzler AV, Johnson DL. Single-Bundle Anatomic Anterior Cruciate Ligament Reconstruction: Surgical Technique Pearls and Pitfalls. Clin Sports Med. 2017;36(1):53-70.
Chuaychoosakoon C, Parinyakhup W, Wiwatboworn A, Purngpiputtrakul P, Wanasitchaiwat P, Boonriong T. Comparing post-operative pain between single bundle and double bundle anterior cruciate ligament reconstruction: a retrospective study. BMC Musculoskelet Disord. 2021 ;22(1):753. doi: 10.1186/s12891-021-04635-5.
Chen H, Chen B, Tie K, Fu Z, Chen L. Single-bundle versus double-bundle autologous anterior cruciate ligament reconstruction: a meta-analysis of randomized controlled trials at 5-year minimum follow-up. J Orthop Surg Res. 2018;13(1):50. doi: 10.1186/s13018-018-0753-x.
Chen K, Zhu W, Zheng Y, Zhang F, Ouyang K, Peng L, Liu H, Feng W, Huang Y, Zhang G, Deng Z, Lu W. A retrospective study to compare the clinical effects of individualized anatomic single- and double-bundle anterior cruciate ligament reconstruction surgery. Sci Rep. 2020 ;10(1):14712.
Brophy RH, Wright RW, Matava MJ. Cost analysis of converting from single-bundle to double-bundle anterior cruciate ligament reconstruction. Am J Sports Med. 2009 ;37(4):683-687.
Sun L, Zhao J, Shen J, Du B, Yuan B. Anatomic single-bundle anterior cruciate ligament reconstruction in Asian population. ANZ J Surg. 2013;83(4):262-7. doi: 10.1111/j.1445-2197.2012.06317.x.
Smith TO, Davies L, Hing CB. Early versus delayed surgery for anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2010 ;18(3):304-311.
Parkinson B, Robb C, Thomas M, Thompson P, Spalding T. Factors That Predict Failure in Anatomic Single-Bundle Anterior Cruciate Ligament Reconstruction. Am J Sports Med. 2017;45(7):1529-1536.
