Summary

preserved insertion technique is better in early follow up in terms of graft re-rupture

Abstract

Introduction

Graft selection is an important aspect of ACL reconstruction surgery. An ideal graft should be of proper biomechanical strength, sufficient size, reliable fixation, rapid biological healing, no biologically adverse reaction, no donor site morbidity and excellent long term outcome. Tibial insertion preserving hamstring graft can prevent potential problems of free graft in anterior cruciate ligament (ACL) reconstruction such as pull out before graft-tunnel healing or rupture before ligamentization of the graft.

Material And Methods

We analysed 80 patients of ACL injury in a prospective trial where 40 patients were operated with free hamstring graft and 40 patients were operated with preserved insertion hamstring graft. The duration of study was 3 years from October 2015 to November 2015 with a minimum follow up of 2 years. The patients were divided in two groups of 40 persons each with the first group operated with free hamstring graft and the second group with preserved insertion hamstring graft. Preoperative clinical and radiological findings were documented along with post op clinical and radiological findings. Functional outcome was assessed with Lysolm`s score, Tegner`s activity score and Hop test at 1 year and 2 year intervals.

Results

Results were compared between the two groups. In Group 1 the mean age is 29.0±8.4 yrs. The mean height, weight and thigh circumference is 169.6±5.7 cm, 72.5±6.9 kgs and 50.1±6.6 cm respectively. In Group 2 the mean age is 26.9±6.7 yrs. The mean height, weight and thigh circumference is 167.6±5.8 cm, 72.2±5.7 kgs and 47.5±5.0 cm respectively.
In group 1 preoperative Lysolm score was 45.8±10.3 which rose to 93.7±4.8 at 1st year follow-up and 94.0±5.0 at 2nd year follow-up. 35 out of 40 patients were able to return to their previous activity level with mean duration of return being 10.1±2.7 months. In group 2 preoperative Lysolm score was 42.7±11.7 which rose to 94.7±3.8 at 1st yr. follow-up and 95.2±3.9 at 2nd yr. follow-up (Table 4). 37 out of 40 patients were able to return to their previous activity level with mean duration of return being 8.7±2.2 months.

Conclusion

The preserved insertion hamstring graft group had better clinical, functional and radiological results as compared to free hamstring graft group over a follow-up period of 2 years.
Keywords
ACL, Preserved insertion, hamstring graft