Stability Results of Hamstring Anterior Cruciate Ligament Reconstruction at Two- to Eight-Year Follow-Up
By
Chadwick C. Prodromos M.D., Yung S. Han B.S., Brett L. Keller, B.S, B.A., Richelle J. Bolyard, B.A.
Published in:
Arthroscopy: The Journal of Arthroscopic and Related Surgery
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ABSTRACT
PURPOSE: The purpose of this study was to test the hypothesis that hamstring (HS) anterior cruciate ligament (ACL) reconstructions using Endobutton femoral and whipstitch/screw tibial fixation can produce a high rate of objective stability in a population of reconstructed patients with low morbidity.
TYPE OF STUDY: Case series
METHODS: 153 consecutive primary HS ACL reconstructions in skeletally mature patients without other ligament reconstructions were retrospectively reviewed. All knees had Endobutton femoral and whipstitch/screw tibial fixation. 139 were found and 133 were tested. 13 were geographically distant and tested subjectively only. Evaluations included KT-1000 testing; radiographs; and Noyes, Lysholm, and Single-Assessment-Numeric-Evaluation (SANE) ratings. Follow-up was 24-104 months (mean 54.4).
RESULTS: There were no graft failures. No patient had rupture of an implanted graft. No patient had repeat surgery for instability. 96.9% of reconstructions had maximum manual side-to-side differences of £3mm, 85.7% had £2mm.3% of the knees had a 4mm difference; none had ³5mm.
There was no objective stability difference between males and females and no deterioration in results with increasing follow-up time. Median ratings were: Noyes 94, Lysholm 94.5, and SANE 90. Radiographs showed that no Endobuttons migrated. No Endobutton or tibial screw had to be removed due to symptoms from the implant. 118 of 120 patients had full extension; the other 2 patients had a 2-degree flexion loss. One patient required repeat arthroscopy for arthrofibrosis but had full ROM at follow-up. There were no deep knee infections. One patient had a superficial wound infection requiring intravenous antibiotics. One patient had a calf deep vein thrombosis that resolved with treatment.
CONCLUSIONS: Hamstring ACL reconstructions can produce: 1) reliable, durable stability in both males and females with no graft failures, 2) good clinical ratings, 3) excellent range of motion, 4) low morbidity, without hardware problems.
Key words: Anterior Cruciate Ligament Reconstruction – Semitendinosus and Gracilis – Hamstring – Stability – Outcomes
This article was published in Arthroscopy: The Journal of Arthroscopic and Related Surgery,
Volume 21, by C.C. Prodromos, et al.
Stability Results of Hamstring Anterior Cruciate Ligament Reconstruction at Two- to Eight-Year Follow-Up,
pages 138-146, Copyright 2005, and is posted with permission from the Arthroscopy Association of North America