Quadruple hamstring anterior cruciate ligament reconstruction

Scranton, Pierce E.; Bagenstose, James E.; Lantz, Brick A.; Friedman, Marc J.; Khalfayan, E.Edward; Auld, M.Kevin

doi:10.1053/jars.2002.35262

Cited by 49 publications

(29 citation statements)

References 23 publications

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“…However, several drawbacks remain unsolved because postoperative morbidities, such as anterior knee pain on climbing stairs, after long periods of sitting, or while kneeling, have been reported [8,38,42]. Moreover, quadriceps or hamstring isokinetic strength deficits [9,36], postoperative range of motion restriction [17], late postoperative graft elongation and subsequent laxity [7,34,37], patellar tendon shortening or rupture [28,29], and patellofemoral osteoarthritis [38] have been reported, and the quadriceps tendon has been found to have potential advantages as a graft in these aspects [13,15,41,44]. This study has some inherent weaknesses because of its retrospective nonrandomized treatment selection and differing methods of graft fixation in the two groups.…”

Section: Discussionmentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction

Han

Seong

Lee

et al. 2008

Clinical Orthopaedics &Amp; Related Research

145

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The bone-patellar tendon-bone has been widely used and considered a good graft source. The quadriceps tendon was introduced as a substitute graft source for bonepatellar tendon-bone. We compared the clinical outcomes of anterior cruciate ligament reconstructions using central quadriceps tendon-patellar bone and bone-patellar tendonbone autografts. We selected 72 patients who underwent unilateral anterior cruciate ligament reconstruction using bone-patellar tendon-bone between 1994 and 2001 and matched for age and gender with 72 patients who underwent anterior cruciate ligament reconstruction using quadriceps tendon-patellar bone. All patients were followed up for more than 2 years. We assessed anterior laxity, knee function using the Lysholm and International Knee Documentation Committee scores, and quadriceps strength, the means of which were similar in the two groups. More patients (28 or 39%) in the bone-patellar tendon-bone group reported anterior knee pain than in the quadriceps tendon-patellar bone group (six patients or 8.3%). Anterior cruciate ligament reconstruction using the central quadriceps tendon-patellar bone graft showed clinical outcomes comparable to those of anterior cruciate ligament reconstruction using the patellar tendon graft, with anterior knee pain being less frequent in the former.Our data suggest the quadriceps tendon can be a good alternative graft choice. Level of Evidence: Level III Therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction

Han

Seong

Lee

et al. 2008

Clinical Orthopaedics &Amp; Related Research

145

View full text Add to dashboard Cite

show abstract

“…As a result, the hamstring tendon has mostly become the graft of choice for ACL reconstructions [9,14,35,37]. Although excellent results are reported for reconstructions with hamstring tendons, complications such as laxity, tunnel widening and loss of flexion strength are also observed [7,10,31,32,38].…”

Section: Discussionmentioning

confidence: 99%

The mid- to long-term results of the anterior cruciate ligament reconstruction with hamstring tendons using Transfix technique

Aşık

Şen

Tuncay

et al. 2007

Knee Surg Sports Traumatol Arthr

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In this study, mid to long-term results of anterior cruciate ligament reconstruction with hamstring tendons and Transfix technique were evaluated. Anterior cruciate ligament (ACL) reconstruction with four-strand hamstring tendon was performed with Transfix technique on 271 (198 males, 73 females; mean age 25.7; 17-52) patients with anterior cruciate ligament ruptures. The patients were followed up with clinical examination, Lysholm and Tegner activity scales, IKDC scoring system, KT-1000 test and radiological examination. The mean follow-up period was 82 (48-100) months; 204 (75%) patients had no subjective complaints. According to the KT-1000 test, only 14 (5%) patients had more than 5 mm laxity postoperatively, whereas, 161 (59%) patients had more than 5 mm laxity preoperatively. In addition to this, only 19 (7%) patients had Lysholm scores less than 80 postoperatively, whereas 154 (57%) patients scored less than 80 preoperatively. When compared with Tegner activity scale, 189 (70%) patients scored<6 preoperatively and only 24 (8%) postoperatively; 78 (29%) patients scored D preoperatively and only 5 (2%) patients scored D postoperatively on the basis of the IKDC scoring system. Our functional results were found to be satisfactory in more than 90% of patients. Commonly seen problems in ACL reconstruction such as inaccurate graft placement and tunnel widening were found to be consistent with the values in relevant literature. However, we demonstrated that the functional results and the stability of the knee were not related with tunnel widening. This study concludes that the reconstruction of ACL with hamstring tendons and the Transfix technique is reasonably successful, safe and causes low morbidity. Furthermore, we believe that proper graft preparation, accurate tunnel placement, notch-plasty, fixation and rehabilitation program are all as important as the choice of graft and fixation material.

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“…The technique was similar to that developed by Pinczewski and the details of the operation have already been reported [39].…”

Section: Surgical Techniquementioning

confidence: 96%

Anterior cruciate ligament reconstruction with double-looped semitendinosus and gracilis tendon graft directly fixed to cortical bone: 5-year results

Giron

Aglietti

Cuomo

et al. 2004

Knee Surg Sports Traumatol Arthrosc

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Forty-three patients who had undergone an anterior cruciate ligament (ACL) reconstruction using a doubled semitendinosus and gracilis graft were prospectively reviewed at 5-year follow-up. All had suffered subacute or chronic tears of the ligament. At surgery, the femoral tunnel was drilled first through the antero-medial portal. The correct position of the femoral and tibial guide wire was checked fluoroscopically. A cortical fixation to the bone was achieved in the femur with a Mitek anchor, directly passing the two tendons in the slot of the anchor, and in the tibia with an RCI screw, supplemented with a spiked washer and bicortical screw. Rehabilitation was aggressive, controlled and without braces. The International Knee Documentation Committee (IKDC) form, KT-1000 arthrometer, and Cybex dynamometer were employed for clinical evaluation. A radiographic study was also performed. At the 5-year follow-up all the patients had recovered full range of motion and 2% of them complained of pain during light sports activities. Four patients (9.5%) reported giving-way symptoms. The KT-1000 side-to-side difference was on average 2.1 mm at 30 lb, and 68% of the knees were within 2 mm. The final IKDC score showed 90% satisfactory results. There was no difference between the 2-year and 5-year evaluations in terms of stability. Extensor and flexor muscle strength recovery was almost complete (maximum deficit 5%). Radiographic study showed a tunnel widening in 32% of the femurs and 40% of the tibias. A correlation was found between the incidence of tibial tunnel widening and the distance of the RCI screw from the joint (the closer the screw to the joint, the lower the incidence of widening). In conclusion, we can state that, using a four-strand hamstring graft and a cortical fixation at both ends, we were able to achieve satisfactory 5-year results in 90% of the patients.

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Quadruple hamstring anterior cruciate ligament reconstruction

Cited by 49 publications

References 23 publications

Anterior Cruciate Ligament Reconstruction

Anterior Cruciate Ligament Reconstruction

The mid- to long-term results of the anterior cruciate ligament reconstruction with hamstring tendons using Transfix technique

Anterior cruciate ligament reconstruction with double-looped semitendinosus and gracilis tendon graft directly fixed to cortical bone: 5-year results

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