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

Int Orthop. 2019 Nov;43(11):2557-2562. doi: 10.1007/s00264-019-04392-0. Epub 2019 Aug 24.

Abstract

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.

Keywords: ACL reconstruction; Hamstrings; Isokinetic; Ligamentoplasty.

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Anterior Cruciate Ligament / physiology
  • Anterior Cruciate Ligament / physiopathology
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries / physiopathology
  • Anterior Cruciate Ligament Injuries / rehabilitation
  • Anterior Cruciate Ligament Injuries / surgery*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Anterior Cruciate Ligament Reconstruction / rehabilitation
  • Female
  • Follow-Up Studies
  • Hamstring Muscles / transplantation*
  • Humans
  • Lysholm Knee Score
  • Male
  • Middle Aged
  • Prospective Studies
  • Recovery of Function
  • Rupture
  • Young Adult