Clinical, functional, and isokinetic study of a prospective series of anterior cruciate ligament ligamentoplasty with pedicular hamstrings.

Int Orthop

Service de Chirurgie Orthopédique et de Traumatologie du membre inférieur, CHU Hautepierre 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg Cedex, France.

Published: November 2019

Purpose: Few studies describe the specific results of anterior cruciate ligament reconstruction with pedicled hamstring graft (HG). Our goal was to report the isokinetic, clinical, and functional outcomes over the post-operative year following pedicled hamstring ligamentoplasty.

Methods: Twenty-four patients with ACL rupture (mean age 27.4 years) were included prospectively. The technique used a four-stranded HG transplant pedicled to the tibia. The functional result (Lysholm knee score and subjective IKDC score), clinical result (KT-1000, Lachman test, joint amplitudes, objective IKDC score), and isokinetic complication occurrence were analyzed at six months and 12 months follow-up. The functional results, clinical parameters, and complications were analyzed at 30 months follow-up. The comparison of the variables with the various regressions was carried out by a Wilcoxon sign test.

Results: Twenty-one patients were reviewed at six, nine, 12, and 30 months. The mean Lysholm knee score was 90/100 at six months, 96/100 at one year, and 95/100 at 30 months. The mean subjective IKDC score was 77/100 and 89/100 at six and 12 months, and 91/100 at 30 months. The mean difference in laxity compared with the healthy knee was 1.4 mm at six months, 1.9 mm at 12 months, and 2 mm at 30 months. The objective IKDC score was A or B for all patients at 12 and 30 months. The average quadriceps strength deficit decreased from 27 to 16% between six and 12 months post-operative (p = 0.0091) and the average flexor deficit from 23 to 12% (p = 0.0084). No complications were identified.

Conclusion: The abovementioned technique allows reaching functional, clinical, and isokinetic results comparable with the standard techniques while preserving the mechanical and biological interest of tibial insertion.

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http://dx.doi.org/10.1007/s00264-019-04392-0DOI Listing

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