A medium to long-term follow-up of ACL reconstruction using double gracilis and semitendinosus grafts

Abstract

This paper reports the results of our approach to ACL tears and knee laxity, based on 30 years of experience in ACL reconstruction with hamstrings and founded on the following cornerstones: the use of doubled semitendinosus and gracilis as a free graft; the use of an out-in technique for femoral drilling and of very strong and stiff fixation devices; the careful examination and repair or reconstruction of the lateral compartment in selected patients; and the use of unaggressive rehabilitation. We prospectively evaluated a series of 100 consecutive patients who underwent ACL reconstruction between 2001 and 2002. A clinical and radiological follow-up was performed at a minimum of 6 years. After 6 years, the International Knee Documentation Committee score demonstrated good-to-excellent results (A and B) in 98% of patients. However, arthrometric results using the KT-1000 demonstrated that 6/80 patients (7.5%) had >5 mm manual maximum side-to-side difference. The median Tegner activity score was 5 (range 1-9); the median Lysholm score was 96 (range 81-100); and the median subjective IKDC score was 94 (range 66-100). We reported 6/80 failures as revealed by a 2+ or 3+ pivot-shift test result and/or KT-1000 side-to-side difference of more than 5 mm. The IKDC score revealed excellent results in all women who underwent extra-articular tenodesis. Radiographic evaluation demonstrated early signs of osteoarthritis in 9% of patients.

Knee stability after anterior cruciate ligament reconstruction in patients older than forty years: comparison between different age groups

“…More patients in this age group with an ACL tear are now considering the possibility of ACL reconstruction. Moreover, such patients have a strong determination to return to their preinjury activity level compared with younger patients [5]. It must also be noted that ACL reconstruction can successfully restore knee stability, which is useful in activities of daily living.…”

“…To compare clinical and arthrometrical results of different age groups, reference was made to a previously published study [5] from our medical institution assessing patients operated with the same surgical protocol over a similar time period. As a result, three patient groups were considered for this study: group 1, patients >40 years (36; 27 men, nine women); group 2, patients 30-40 years (25); group 3, patients <30 years (27).…”

Validity of Single Leg Hop Test in Comparison of Lysholm Score after ACL Reconstruction through Anteromedial Portal Technique by Using Hamstring Tendon

“…Matthias Buchner, et al [20] showed complications like re surgery in 13% of patients and re rupture at follow up in 7% of patients. On the other hand Andrea Ferretti et al [24] showed no complications at all. Complication in our study is only 8.33% with one patient showing signs of infection and one patient having persistent pain at 6 months of follow up.…”

“…H. E. Bourke, D. J. Gordon et al [25] showed the mean Lysholm knee score at 15 years to be 93; a total of 143 patients (94%) had a good or excellent Lysholm score at one year and 134 (88%) had good or excellent scores at 15 years. Andrea Ferretti et al [24] showed improvement of Lysholm score from 57 preoperatively to 96 at follow up (P<0.05). In our study a significant improvement is shown in the mean Lysholm score which increased from 49.12 ± 14.1 to 89.96 ± 7.9 at final follow up (p <0.05).…”

“…The mean time of follow up in different studies are shown in Table 2. Table 2. STUDY MEAN FOLLOW UP TIME Matthias Buchner, et al [20] 6 years and 4 months P. Saravanan, Dobson Dominic [18] 2 years Vernon J. Cooley, et al [27] 5.7 years Andrea Ferretti et al [24] 6 years Georgios Koutras, et al [33] 6 months Chen Y, Zhu W, Wang W [34] 1 year and eight months Present study assessed the short-term clinical outcome with median follow up time of 7.5 months. Although, some studies show that 6 months is adequate time to return to sporting activities after an ACL [33] and measurement of clinical scores and functional tests are valid at 6 month time, (31) this short term follow up period is one of the limitations to this study.…”