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Outcome of Hamstring Autograft With Preserved Insertions Compared With Free Hamstring Autograft in Anterior Cruciate Ligament Surgery at 2-Year Follow-up. | LitMetric

AI Article Synopsis

  • - This study aimed to evaluate the mechanical stability, functional outcomes, and sports activity levels in athletes who underwent ACL reconstruction using two different hamstring graft techniques over a 2-year period.
  • - Results indicated that patients using the technique preserving the graft's insertions showed better knee stability and functional scores compared to those using a free hamstring graft.
  • - However, despite these statistical advantages, the research concluded that there was no clinically significant difference in outcomes between the two graft techniques.

Article Abstract

Purpose: To compare mechanical stability, functional outcome, and level of return to sports activity in patients undergoing anterior cruciate ligament (ACL) reconstruction with a free hamstring graft versus a graft with preserved insertions at 2-year follow-up.

Methods: This study was a prospective, single-blind (the evaluator was blinded), randomized trial of 110 adult professional athletes who were randomly allocated into 2 groups. Group 1 consisted of 55 patients who underwent ACL reconstruction with hamstring tendon autograft with preserved insertions (technique 1), and group 2 consisted of 55 patients who underwent ACL reconstruction with free hamstring tendon autograft (technique 2). An anteromedial portal was used for drilling of the femoral tunnel in all cases. Patients were assessed for a minimum follow-up of 2 years with clinical tests, the Activities of Daily Living Function Scale and Sports Function Scale (Cincinnati knee score), knee arthrometer (KT-1000) testing, and the Tegner activity scale.

Results: The average age of the patients was 27.0 ± 7.5 years in group 1 and 27.2 ± 5.7 years in group 2. At 24 months, the mean side-to-side difference by KT-1000 testing was 1.4 in group 1 and 2.2 in group 2 (P < .0001); the mean Cincinnati knee score (Activities of Daily Living Function Scale and Sports Function Scale) was 418.5 (median, 420; range, 400-420) and 406.8 (median, 420; range, 350-420), respectively (P < .0001); and the mean difference between the preinjury and postsurgery Tegner level of sports activity was 0.3 and 1.08, respectively (P = .027).

Conclusions: Although ACL reconstruction using hamstring autograft with preserved insertions resulted in statistically superior anterior stability, a better functional outcome, and a closer return to the preinjury level of sports activity as compared with free autograft, no clinically significant difference was proved.

Level Of Evidence: Level I, randomized controlled trial.

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Source
http://dx.doi.org/10.1016/j.arthro.2017.06.040DOI Listing

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