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KMID : 0828620080120020112
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Journal of Korean Arthroscopy Society
2008 Volume.12 No. 2 p.112 ~ p.117
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Double-bundle Anterior Cruciate Legament Reconstruction using Autogenous Hamstring Grafts
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Choi Nam-Yong
Song Hyun-Seok
Moon Chan-Woong
Yang Young-Jun
Han Chang-Hwan
Nam Won-Sik
Kwon Jae-Young
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Abstract
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Purpose: Double-bundle reconstruction of anterior cruciate ligament(ACL) has the advantage of restoring the isometry and original function of ACL. The purpose of this study is to evaluate the clinical results following double-bundle reconstruction of ACL using autogenous hamstring grafts through an accessory anteromedial portal.
Materials and Methods: From January 2005 to July 2006, sixty patients(52 males, 8 females) underwent double-bundle ACL reconstruction using autogenous hamstring tendons..The mean age was 31.7 years( years). The mean follow up period was 13.4 months( months). We made a horizontal-oblique skin incision just medial to tibial tuberosity and harvested semitendinosus and gracilis tendon. Tibial tunnel for posterolateral bundle was made near its anatomical position. By modifying an anatomic reconstruction of ACL by Yasuda et al., we made a femoral tunnel for posterolateral bundle through accessory anteromedial portal. Tunnels for anteromedial bundle were made with conventional method. We reconstructed anteromedial bundle with semitendinosus tendon and posterolateral bundle with gracilis tendon. Clinical results at last follow up were evaluated by range of motion, extent of anterior displacement(KT-1000 arthrometer), pivot-shift test. Functional evaluation of clinical outcomes were evaluated by Lysholm score and modified Feagin Scoring System.
Results: There was no limitation of motion of knee joint at last follow up. Mean side to side difference of anterior displacement of tibia by KT-1000 arthrometer was improved from 8.4 mm preoperatively to 1.7 mm postoperatively(p<0.05). Average Lysholm score was improved from 64.1 preoperatively to 92.2 postoperatively(p<0.05). In modified Feagin Scoring System, 90% of cases were rated as good or excellent.
Conclusion: Double-bundle reconstruction of ACL using autogenous hamstring grafts through accessory anteromedial portal results in good clinical outcomes.
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KEYWORD
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Anterior cruciate ligament, Double-bundle reconstruction, Autogenous grafts
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