Summary

ACL reconstruction using semi tendinous graft , with preservation of the tibial insertion, giving options of less implant cost and significant proprioceptive outcome.

Abstract

Introduction

The technique of arthroscopic anterior cruciate ligament reconstruction has undergone many modifications in the recent times with improved understanding of anatomy, kinematics, and biology of the graft. Our case series describe the technique with preserving semi-T tibial insertion, eliminating the need for a tibial side fixation implant. METHODOLOGY: 700 patients with complete ACL tear were operated by same surgeon in two different hospitals in last 8 years. The semi-T was harvested with open stripper and augmented with fiber wire, tunneling was done and suspensory fixation on femoral side . The free distal end is sutured to the itself and periosteum. The mean age was 33 years and 1 year follow up was completed in 654 patients. The functional and proprioceptive outcome was assessed. RESULTS : Functional outcome was good to excellent in our study group IN 93% of patients. Post operative IKDC score is 81.6 compared to pre operative IKDC score 35.8. No graft failure was noted, and 9 cases came up after re-tear due to injury. One infection was noted. CONCLUSION: The main finding of this study is preserving semi-T graft without a tibial implant is a simple, time saving, cost effective technique providing satisfactory outcome with no complications like bio-screw reaction, graft loosening and laxity. All the patients returned to their pre-injury level of activity and good proprioceptive outcome .