EVALUATION OF ARTHROSCOPIC A CRUCIATE LIGAMENT ECONSTRUCTION WITH HAMSTRINGS TENDON GRAFT
Abstract
ABSTRACT
Objective: Treatment of rupture of anterior cruciate ligament (ACL) aims to restore normal/near normal stability and function of the knee, preventing
further damage to other knee structures. We studied the functional outcome of arthroscopic guided ACL reconstruction using quadrupled hamstring
tendon graft (QHTG) and evaluated the complications.
Methods: In this prospective study, evaluation parameters Lachman test, Pivot test, and hamstring strength were assessed pre- and post-operatively
at months 3, 6, 12, 18, and 24; Lysholm test was assessed postoperatively. Intravenous ceftriaxone+tazobactam 1 g b.d × 2 days followed by oral
cefpodoxime 200 mg b.d was prescribed till suture removal. Post-operative ACL rehabilitation protocol was followed for all patients.
Result: A total of sixteen male patients with a mean age of 26.5 years were evaluated. Injury due to road traffic accident (7) and sports activity (6)
was a common cause. Preoperatively, all patients had positive Pivote and anterior drawer test, 4+ score of Lachman test, 4/5 muscle strength with
restriction of movement to <10°. Mean±standard deviation Lysholm score at months 3, 6, and 12 were 81.19±10.21, 83.86±12.44, and 89.17±8.32,
respectively. At month 3, negative Lachman test was seen in 75% (12/16) patients, 18.75% (3/16) had 1+ laxity, and only one had 2+ laxity. None had
pivot shift test positive. At month 3, 81.25% (13/16) patients had normal range of motion of the operated knee; at month 6 and 12, 85.71% (12/14)
and 91.67% (11/12), respectively, had equal range of motion compared to normal contralateral side. At months 3 and 12, 37.5% (6/16) and 100%
(12/12) had a grade of 5/5 power in hamstring muscles. 12 post-operative complications were seen in 10 patients.
Conclusion: Autologous ipsilateral QHTG is a good choice in arthroscopic guided ACL reconstruction and is associated with fewer complications.
Focus on regaining hamstring power is essential for a successful surgery.
Keywords: Anterior cruciate ligament tear, Hamstring strength, Lysholm score, Pivote test, Quadrupled hamstring tendon graft, Range of movement.
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References
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