Over-the-Top Anterior Cruciate Ligament Reconstruction Using Single- or Double-Strand Hamstrings Autograft

Abstract

The purpose of this study is to (1) report the long-term clinical and radiographic outcomes of a nonanatomical anterior cruciate ligament (ACL) reconstruction using an over-the-top (OTT) femoral route and (2) compare single-strand (1SHG) and double-strand (2SHG) hamstrings graft reconstruction. Fifty-one consecutive patients (mean age, 29.2±3.8 years) underwent nonanatomical ACL reconstruction using OTT femoral passage. Twenty patients underwent 1SHG reconstruction and 31 underwent 2SHG reconstruction. International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner score, and KT-1000 (Medmetric Corporation, San Diego, California) evaluation were recorded at a mean follow-up of 12.1±1.6 years. At final follow-up, radiographic evaluation was performed according to the IKDC grading system. Mean IKDC subjective score at follow-up was 76.6±21.9 in the 1SHG group and 88.9±10.0 in the 2SHG (P=.009). Average KOOS was 82.6±18.7 in the 1SHG group and 92.4±9.2 in the 2SHG group (P=.016). Objective IKDC evaluation showed a higher percentage of normal knees in the 2SHG group (P=.018). Pivot shift testing revealed a significantly higher number of normal knees in the 2SHG group (P=.001). Radiographs showed fewer degenerative changes in the 2SHG group at final follow-up in the medial (P=.01) and lateral (P=.037) compartments. Nonanatomical ACL reconstruction using the OTT technique provided satisfactory results in terms of control of both static and dynamic instability at long-term follow-up, thus preventing degenerative joint disease. The 2SHG group showed better subjective and functional outcomes with fewer degenerative changes compared with the 1SHG group at long-term follow-up.

High Rates of Osteoarthritis Develop After Anterior Cruciate Ligament Surgery: An Analysis of 4108 Patients

“…Seventeen studies compared bone–patellar tendon–bone reconstruction autografts with hamstring reconstruction autografts; 5 compared nonoperative and operative treatment; 3 compared single- and double-bundle reconstruction; and 13 were classified as “other.” Four studies fell into the “other” category because there was not at least 1 additional study with the same comparison groups. Comparisons in these studies included bone–patellar tendon–bone autograft reconstruction versus Kennedy augmentation, 12 accelerated versus delayed rehabilitation, 23 medial meniscus transplant with ACLR versus a collagen meniscus implant with ACLR and single- versus double-strand hamstring ACLR, 47 and screw versus pin femoral fixation. 6 The remaining 9 studies in the “other” group were prospective (prognostic) cohort studies.…”

What’s the rate of knee osteoarthritis 10 years after anterior cruciate ligament injury? An updated systematic review

“…Of these, 23 had a prospective study design, and 18 had a retrospective study design. [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60]…”

Arthroscopic Anterior Cruciate Ligament (ACL) Reconstruction Using Hamstring Tendon at the Order of Malta's Hospital Center in Dakar

“…We used Non-anatomical ACL reconstruction using the Over the Top technique provided satisfactory results in terms of control of both static and dynamic instability at long-term follow-up. However, the 2SHG group showed better subjective and functional outcomes with fewer degenerative changes at long-term follow-up compared with the 1SHG group [33].…”