Outcome of hamstring graft with preserved insertion: Prospective Study with 5 year Follow-up

Abstract

BackgroundAutologous hamstring graft remains to be a commonly used graft for Anterior Cruciate Ligament (ACL) in sportspersons. With less graft failure rates, better mechanical stability and proprioception with preserved insertion hamstring graft, we investigated long term outcomes of hamstring graft with preserved insertion. Methods: 441 sportspersons were enrolled in the study. They were divided into two groups by computerized randomization. In Group I, ACL reconstruction was done using hamstring free graft (STGF), and in Group II, ACL reconstruction was done using hamstring graft with preserved tibial insertion (STGPI). Postoperatively, patients were assessed for graft rupture, knee stability, Lysholm score, tegner activity and WOMAC score.ResultsThe average age of the patients was 24 ± 2 years in group 1 and 27 ± 8.5 years in group 2. At 5 years, the mean KT-1000 difference was 2.01 in group 1 and 1.96 in group 2 (P = 0.77); the mean Lysholm score was 97.80 and 98.60(p = 0.07), respectively; mean WOMAC score was 3.09 and 3.12(p = 0.89) respectively; mean difference between the pre-injury and post-surgery Tegner level of sports activity was 1.78 and 0.54(P < 0.05), respectively and graft failure rate was 4.1% and 7.7%.(p < 0.05), respectively.ConclusionWe report STGPI to be a more viable option than hamstring free graft in sportspersons for ACL reconstruction due to less graft failure rates and better tegner activity score postoperatively. Further, STGPI is an option with low graft failure rate like that of Bone Patellar Tendon Bone graft,with added advantage of not having significant donor site morbidity.Level of EvidenceLevel 1, Randomized Controlled Trial