Arthroscopic ACL Reconstruction using Preserved Insertion Hamstring Graft - A Prospective Short - Term Analysis

Introduction Graft selection is an important aspect of ACL reconstruction surgery. An ideal graft should be of proper biomechanical strength, sufficient size, reliable fixation, rapid biological healing, no biologically adverse reaction, no donor site morbidity and excellent long term outcome. Tibial insertion preserving hamstring graft can prevent potential problems of free graft in anterior cruciate ligament (ACL) reconstruction such as pull out before graft-tunnel healing or rupture before ligamentization of the graft. Material and methods We analysed 60 patients of ACL injury in a prospective trial where all the patients were operated with preserved insertion hamstring graft. The duration of study was 3 years from October 2015 to November 2018 with a minimum follow up of 2 years. Preoperative clinical and radiological findings were documented along with post op clinical and radiological findings. Functional outcome was assessed with Lysolm`s score, Tegner`s activity score and Hop test at 1 year and 2 year intervals. Results Of the 60 patients, the mean age is 26.5±6.0 yrs. The mean height, weight and thigh circumference is 167.5±6.0 cm, 72.7±5.6 kgs and 47.8±4.8 cm respectively. Pre operative Lysolm score was 42.3±11.5 which rose to 94.4±3.8 at 1st yr followup and 95.0±3.8 at 2nd yr followup.56 out of 60 patients were able to return to their previous activity level with mean duration of return being 8.8±2.3 months. Limb Similarity Index (LSI) as measured by single leg hop, triple hop and crossover hop is 93.5 % at 1 year and 95.1 % at 2 year. Conclusion In our study, we found that preserved insertion hamstring graft is a good option for arthroscopic ACL reconstruction with good clinical, radiological and functional outcomes