Title: Short-Term Functional Outcomes in Five Strand Hamstring Graft for Anterior Cruciate Ligament Reconstruction among Young Adults – A Prospective Pilot Study
Authors: Dr Sumit Kumar Goyal, Dr Navin Kumar, Dr Gopisankar Balaji, Dr Jagdish Menon, Dr Sandeep Nema, Dr J. Mohanakrishnan
DOI: https://dx.doi.org/10.18535/jmscr/v9i6.12
Abstract
Anterior Cruciate Ligament (ACL) injuries are common sports injuries and ACL doesn’t have healing property. So, it is repaired by graft surgery. This pilot study assess the short-term functional outcomes among young adults undergoing five strand Hamstring graft for anterior cruciate ligament injury using IKDC score. A total of 14 patients were included in the study and were followed up for 6 months post ACL reconstruction. The ACL injuries are more common in physically active age group of 20 to 40 years. We found that pre-operative Mean IKDC scores were 43.22+/- 9.91. IKDC scores at 6 months follow up were improved to 92.6+/- 1.85 with significant differences (p- value<0.001). There was improvement in Pain Visual Analog score (VAS) from mean pre-operative VAS score was with standard deviation 1.21 to post-operative VAS score 1.07 with standard deviation 1.49 (p value<0.0001). The results of this study can be used to plan a bigger study with a large sample size and extended follow-up.
Keywords: ACL injuries, reconstruction, five-strand hamstring graft.
References
- Lee RJ, Ganley TJ. The 5-Strand Hamstring Graft in Anterior Cruciate Ligament Reconstruction. Arthrosc Tech. 2014;20;3(5):e627–31.
- Prodromos C, Joyce B. Five-Strand Hamstring Anterior Cruciate Ligament Reconstruction: Presentation of a New Technique with Better Stability at 7- to 9-Year Follow Up Than 4 Strand. Techniques in Orthopaedics. 2005 Sep 1; 20:192–3.
- Lavery KP, Rasmussen JF, Dhawan A. Five-strand hamstring autograft for anterior cruciate ligament reconstruction. Arthrosc Tech.2014;3(4):e423–6.
- Calvo R, Figueroa D, Figueroa F, Vaisman A, Schmidt-Hebbel A, Morales N, et al. Five-Strand Hamstring Autograft Versus Quadruple Hamstring Autograft With Graft Diameters 8.0 Millimeters or More in Anterior Cruciate Ligament Reconstruction: Clinical Outcomes With a Minimum 2-Year Follow-Up. Arthroscopy. 2017May;33(5):1007–13.
- Tutkus V, Kluonaitis K, Silove S, Tutkuviene J. ACL reconstruction using 5- or 6-strand hamstring autograft provides graft‟s diameter bigger than 8 mm. Knee Surg Sports TraumatolArthrosc. 2017 Aug7.
- Hamner DL, Brown CH Jr, Steiner ME, Hecker AT, Hayes WC. Hamstring tendon grafts for reconstruction of the anterior cruciate ligament: biomechanical evaluation of the use of multiple strands and tensioning techniques. J Bone Joint Surg Am1999;81(4):549–57.
- Robinson J, Stanford FC, Kendoff D, Stüber V, Pearle AD. Replication of the range of native anterior cruciate ligament fiber length change behavior achieved by different grafts: measurement using computer-assisted navigation. Am J Sports Med 2009;37(7):1406–11.
- Patel S, Chauhan DV, Juyal A, Maheshwari R, Agrawal A. Evaluation of Arthroscopic Anterior Cruciate Ligament Reconstruction using Hamstring graft. Indian medgazette.2014;10:384-88.
- Sutton KM, Bullock JM. Anterior cruciate ligament rupture: differences between males and females. J Am Acad Orthop Surg. 2013Jan;21(1):41–50.
- Soon M, Neo CPC, Mitra AK, Tay BK. Morbidity following anterior cruciate ligament reconstruction using hamstring autograft. Ann Acad Med Singap. 2004;33(2):214–9.
- Spicer DD, Blagg SE, Unwin AJ, Allum RL. Anterior knee symptoms after four-strand hamstring tendon anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc.2000;8(5):286–9.
- Sgaglione NA, Pizzo WD, Fox JM, Friedman MJ. Arthroscopically assisted anterior cruciate ligament reconstruction with the pes anserine tendons: Comparison of results in acute and chronic ligament deficiency. Am J Sports Med. 1993 Mar1;21(2):249–56.
- Magnussen RA, Lawrence JTR, West RL, Toth AP, Taylor DC, Garrett WE. Graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft. Arthroscopy. 2012;28(4):526– 31.