The knee joint is one of the most commonly injured joint in our body and the most commonly injured ligament is ACL. Due to ever increasing RTA’s and increased participation in sporting activities. There is increase in incidence of ligament injuries of knee. The ACL along with other ligaments, capsule is the primary stabilizer of knee and prevent anterior translation and restricts valgus and rotational stress to certain degree.
Open reconstruction of ACL which was done earlier is not practiced now a day due to complications such as increased Post-operative pain, stiffness and lengthy rehabilitation phase. Arthroscopic reconstruction of the injured ACL has become the gold standard procedure.
The ideal graft for ACL is still a topic of debate. The most commonly used graft are bone patellar tendon bone graft and hamstring graft. The hamstring graft is increasingly used now a day for the following reasons:
. Advanced soft tissue fixation technique
. Increased incidence of anterior knee pain with bone patellar tendon bone graft
This study has been done to evaluate the functional outcome of arthroscopic single bundle anterior cruciate ligament reconstruction using quadrupled hamstring tendon (Gracilis and semitendinosus) autograft in anterior cruciate injuries.
Methods: Twenty cases of arthroscopic anterior cruciate ligament reconstruction were regularly followed for an average period of 17.6 months in mamta medical college, Khammam from august 2019 to march 2021.
Results: Among twenty patients treated with arthroscopic anterior cruciate ligament reconstruction 45% (9 patients) had excellent functional outcome while 40% (8 patients) had good functional outcome and remaining 15% (3 patients) had fair outcome according to LYSHOLM KNEE SCORE. One patient had superficial infection at the donor site which settled with intravenous antibiotics. One patient developed deep infection of the donor site with wound gaping which is managed with wound debridement and secondary closure and was given intravenous antibiotics which is healed well and the sutures removed after 10 days. One patient developed fixed flexion deformity of 10 degree with range of movements ranging from 10 to 90 degree. The patient had poor compliance to rehabilitation protocol. The mean pre-operative IKDC (international knee documentation 2000 score) score was 50.86 while the mean post-operative score was 87.66. there was significant improvement in post-operative IKDC score compared with pre-operative score with P value<0.05.
Conclusion: Arthroscopic anterior cruciate ligament reconstruction with hamstring graft is an excellent treatment option for anterior cruciate ligament deficient knees. And Hamstring graft fixation with endobutton and interference screw gives good functional outcome. Good functional results are achieved by careful preoperative planning and respecting the principles of arthroscopic anterior cruciate ligament reconstruction technique.