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ORIGINAL ARTICLE
Year : 2018  |  Volume : 2  |  Issue : 1  |  Page : 26-30

Study of outcome of 300 cases of arthroscopic anterior cruciate ligament reconstruction with quadrupled hamstrings tendon graft using anterior cruciate ligament tightrope for femoral fixation


Department of Orthopaedics, Naval Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Sanjay K Rai
Department of Orthopaedics, Naval Hospital, RC Church, Colaba, Mumbai - 400 005, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmsr.jmsr_20_17

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Objective: The aim of treatment of tear of the anterior cruciate ligament (ACL) in any military soldiers is to restore normal/near normal stability and function of the knee, preventing further damage to other knee structures and quick return to duty. We studied the functional outcome of arthroscopic-guided ACL reconstruction using quadrupled hamstring tendon graft (QHTG) and femoral side graft fixation using ACL TightRope and also to evaluate its complications. Methods: In this prospective study, evaluation parameters Lachman test, pivot test, and hamstring strength were assessed pre- and post-operatively at 3, 6, 12, 18, and 36 months. Lysholm test was assessed postoperatively. Results: A total of 300 male soldiers with a mean age of 26.5 years were evaluated. Injury due to military training, sports, fall, and road traffic accident was a common cause. Preoperatively, all patients had a positive pivot and anterior drawer tests, 4+ score of Lachman test, and 4/5 muscle strength with restriction of movement to <10°. Mean ± standard deviation Lysholm score at 3, 6, and 12 months were 81.19 ± 10.21, 83.86 ± 12.44, and 89.17 ± 8.32, respectively. At the 3rd month, negative Lachman test was seen in 83.6% (251/300) of patients, 13.6% (41/300) had 1+ laxity, and 2.6% (8/300) patients had 2+ laxity. None had positive pivot shift test. At 3 and 12 months, 91.3% (274/300) and 100% (300/300) had a grade of 5/5 power in hamstring muscles. Fifteen cases developed postoperative complications such as infection and graft failure. Conclusion: Autologous ipsilateral QHTG is a near anatomical and good choice for ACL reconstruction and is associated with fewer complications.


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