Evaluation of functional outcome following transportal arthroscopic anterior cruciate ligament reconstruction using quadrupled hamstring graft

H. Sakale, A. Agrawal, Martha Balakrishna, B. Kar, B. Moti
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Abstract

Introduction: The anterior cruciate ligament (ACL) has an important role in preserving the function and stability of the knee joint, and it prevents anterior translation of the tibia. The ACL is the most commonly injured structure of the knee following posttraumatic and sports-related injuries. The treatment of modality for ACL insufficiency was arthroscopic ACL reconstruction. In this study, we followed the transportal approach for ACL reconstruction using a Quadrupled Hamstring graft, and we reported the functional outcome of ACL reconstruction at a minimum follow-up of 6 months. Materials and Methods: This was a prospective outcome study conducted on 32 patients who met the inclusion and exclusion criteria. All patients in this study underwent arthroscopic reconstruction of ACL using quadrupled hamstring tendon graft through transportal technique. The graft was fixed with an endobutton on the femoral side and an interference screw on the tibial side. Patients were assessed for the functional outcome for a minimum of 6 months using the Tegner-Lysholm knee scoring system. Results: The mean age of the patient was 27 years. The majority of involved patients were males. The left side (77.14%) was involved more than the right side (22.86%). The most common cause of ACL injury in this study was road traffic accidents. Preoperative Tegner-Lysholm scores were 20 (62.5%) patients had poor and 12 (37.5%) patients had fair scores. Post-operatively, at 6 months follow-up, 27 patients had excellent, four patients had good scores, and one patient had a fair score. There was a significant improvement in the Tenger-Lysholm scoring system after 6 months of follow-up when compared to preoperatively. Three patients had knee pain and thigh muscle wasting (2 – 3 cm) during follow-up. Conclusions: Transportal arthroscopic ACL reconstruction using Quadrupled Hamstring graft gives excellent functional outcome and knee kinematics.
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运输关节镜下采用四肢腘绳肌移植重建前交叉韧带后功能结果的评价
前言:前交叉韧带(ACL)在保持膝关节的功能和稳定性方面具有重要作用,它可以防止胫骨的前移位。前交叉韧带是创伤后和运动相关损伤中最常见的膝关节损伤结构。前交叉韧带功能不全的治疗方式为关节镜下前交叉韧带重建。在本研究中,我们采用转运入路使用四肢腘绳肌移植物进行ACL重建,我们报告了至少随访6个月后ACL重建的功能结果。材料和方法:这是一项前瞻性结局研究,对32例符合纳入和排除标准的患者进行研究。本研究中所有患者均采用经转运技术的四股腘绳肌腱移植行关节镜下前交叉韧带重建。移植物在股骨侧用内扣固定,在胫骨侧用干涉螺钉固定。使用Tegner-Lysholm膝关节评分系统评估患者至少6个月的功能结果。结果:患者平均年龄27岁。大多数患者为男性。左侧病变(77.14%)多于右侧病变(22.86%)。本研究中最常见的前交叉韧带损伤原因是道路交通事故。术前Tegner-Lysholm评分差的患者20例(62.5%),评分一般的患者12例(37.5%)。术后随访6个月,优27例,良4例,一般1例。随访6个月后,与术前相比,Tenger-Lysholm评分系统有显著改善。3例患者在随访期间出现膝关节疼痛和大腿肌肉萎缩(2 - 3cm)。结论:在运输关节镜下使用四股腘绳肌移植物重建前交叉韧带具有良好的功能结果和膝关节运动学。
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