- 期刊
Arthroscopic Anterior Cruciate Ligament Reconstruction With Quadruple Hamstring Tendons Autograft-Early Postoperative Follow-up
並列摘要
The treatment of anterior cruciate ligament injuries should be tailored to the individual patient. Indications for surgical reconstruction of ACL tear include a grade III or IV ACL injury, combined ligaments injuries, and symp- tomatic anterior instability. Hamstring tendon autograft has become popular because it avoids postoperative anterior knee pain and donor site morbidity. The purpose of this study is to describe a technique of arthroscopic ACL recon-struction with quadruple hamstring tendons autograft. The graft includes dou-ble loops of the semitendinosus and gracilis ttendons, fixed by Mersilene tape and washer at the femoral side, and with Ethibond sutures to screw at tibial side. Between March 1996 and December 1996, this graft has been used in 26 patients with ACL injuries. All patients were evaluated at an average of 28 (24-30) months. Twenty-two of the 26 patients returned to the same or higher level of pre-injury activity level. The overall outcome of IKDC rating was mormal or nearly normal in 23 of the 26 patients. Overall subjective rating with 100-point Knee Score was 87.4. By Cybex dynamometer, the recovery of quadriceps strength of the operated knee to 80% of the normal knee could be achieved in 24 of the 26 patients. There was only one patient with hamstring muscle power lim-itation at follow-up. For the assessment of tunnel expansion after ACL recon-struction, the diameter of the bone tunnels were measured and compared with the original reamed diameter. Enlargement of at least 2 mm was identified in five femoral tunnels and inthree tibial tunnels of the 26 patients. In conclusion, the use of semitendinosus and gracilis tendon graft in ACL reconstruction is technically easier, safer, and more reproducible. Morbidity from harvesting the hamstring tendons is rare and with minimal residual flexor and extensor strength deficit. We introduce a new fixation technique which is easy to learn and perform. The clinical result at a minimum two-year follow-up with this technique was satisfactory.
延伸閱讀
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