A study of functional outcome in patients undergoing arthroscopic reconstruction of anterior cruciate ligament injury using hamstring tendon graft with interference screws

Abstract

The Anterior Cruciate Ligament is the primary stabilizer of the knee and prevents the knee against anterior translation. It is also important in counteracting the rotational and valgus stress. The arthroscopically aided approach has the advantages of smaller skin and capsular incisions, improved viewing of the intercondylar notch for placement of the tunnel and attachment sites, less postoperative pain, fewer adhesions, earlier motion and easier rehabilitation. Approximately 100,000 anterior cruciate ligament (ACL) reconstructions are performed in the USA each year. Interference screw fixation is considered the standard for rigid fixation of the graft and provides higher fixation strength compared with other devices such as staples or buttons. Most studies showed no intergroup difference in terms of outcomes measured with validated clinical scores such as IKDC (International Knee Documentation Committee), Lysholm score and Tegner activity level. There was no significant difference regarding range of motion. Knee stability as evaluated with pivot shift and KT arthrometer showed a significant difference only in one study, favouring metallic interference screws. Materials and Methods: Patients admitted to CG hospital and Bapuji hospital in Davangere, Karnataka between 2019 October to 2021 October were taken into the study after taking informed consent. Results: This study consists of 25 cases of Anterior Cruciate Ligament injury. All cases were performed arthroscopically. ACL rupture was common in second and third decade. In our study, male preponderance was found with 23 (92%) and female preponderance of 2 (8%). Side affected was 13 (52%) right side and 12 (48%) left side. Mode of injury in the present study includes various sources such as sports, RTA, fall. Results were evaluated by using International Knee Documentation committee (IKDC) and Lysholm knee scoring scale. In present study we have 22 patients with Excellent results, 2 cases as Good, 1 case as Fair and 0 cases as Poor. No case needed re-surgery. In the present study there were no cases of superficial infection. Conclusion: Arthroscopic reconstruction of ACL using Semitendinous and Gracilis tendon graft (Hamstring tendon) with Interference screws can be considered the best mode of treatment for ACL rupture.