Comparative Study of Arthroscopic Anterior Cruciate Ligament Reconstruction by Quadrupled Semitendinosus-Gracilis and Tripled Semitendinosus Auto Graft

Abstract

Background: The anterior cruciate ligament (ACL) is the most frequently disrupted ligament of the knee. Arthroscopic ACL reconstruction is one of the most common orthopaedic procedures now-a-days and has become the gold standard method of treatment in complete ACL tear. Though the choice of graft for ACL reconstruction and the methods of its fixation are matters of debate, hamstring tendon is considered as the favorable graft. Common options for the choice of graft are quadrupled semitendinosus-gracilis and tripled semitendinosus auto graft. Aim of our study is to compare the outcome of arthroscopic ACL reconstruction by quadrupled semitendinosus-gracilis and tripled semitendinosus auto graft.Material & Methods:In this prospective interventional study purposive sampling was done. Sixty patients with complete ACL tear were included in this study from May 2017 to August 2019 at NITOR, strictly considering the inclusion and exclusion criteria. Thirty of them treated with quadrupled semitendinosus-gracilis (group 1) and thirty with tripled semitendinosus (group 2) auto graft. Evaluation by Lysholm knee score was done before and after surgery. Final outcome was evaluated at 24th week post-operatively.Results:Preoperative Lysholm Knee Score was almost similar in group 1 (63.2±2.1) and in group 2 (63.1±2.5). This difference was not statistically significant (p=0.582). Postoperative Lysholm Knee Score at 24th week was slightly higher in group 1 (95.0±2.0) in comparison to group 2 (94.4±3.2). This difference was also not statistically significant (p=0.361). But excellent functional outcome was more in group 1 (80.0%) in comparison to group 2 (73.3%) whereas no poor or fair outcome was reported in group 1 but fair outcome was reported in 6.7% of patients in group 2. Overall complication rate was 6.67% with no significant intergroup difference.Conclusions:Quadrupled semitendinosus-gracilis auto graft has yielded more excellent results than tripled semitendinosus graft. But as this difference was not significant, it can be said that, both the procedure can be performed for arthroscopic reconstruction of ACL.