A study on surgical management of anterior cruciate ligament injuries by arthroscopic reconstruction using semitendinosus and gracilis tendon

Abstract

Background and Objectives: The unprecedented growth and development in the past decade of our country saw rapid growth and urbanization resulted in change in life style of the people and also increase in the sports and other occupational related activities by the individuals. This has led to the increased accidental injuries to the knee joint, a major contributing factor to Anterior Cruciate Ligament (ACL) injury. Arthroscopic ACL reconstruction using quadrupled semitendinosus and gracilis tendon autograft with using endobutton for femoral tunnel fixation and in the tibial tunnel with hybrid fixation using suture disc and anchored with a cancellous screw and washer or interferential screw is a relatively new technique. We have undertaken this study to analyze the postoperative outcome in our experience with this procedure. Methods: This was a prospective study of consecutive patients with ACL injury who underwent Arthroscopic ACL reconstruction in our institution using quadrupled semitendinosus and gracilis tendon autograft. Postoperatively, all patients were initiated on the same rehabilitation protocol. All patients were followed up for four to six months period at regular intervals using IKDC, LGS scoring systems and a subjective questionnaire. Functional assessment with hop test was done. Results: About 92% of the patients had a favourable outcome as per three scoring systems. All three scoring system had a very high correlation as evidenced by the Kendal-tau values ranging x from 0.464 to 0.923. Statistically, this was found to be highly significant (p value- 0.000 – 0.001). Using IKDC scoring, the results were normal in 14, nearly normal in 10 and abnormal 1. 4 patient (16%) presented with anterior knee pain. Sensory loss was noted in 3 patients (12%) at the end of 6 months following surgery. Swelling was present in 4 patients (16%).None were having any infection and FFD. Conclusion: We conclude that the functional outcome of arthroscopic anterior cruciate ligament reconstruction using quadrupled semitendinosus and gracilis tendon autograft is excellent to good (92%). With proper patient selection and physiotherapy regimen, full occupational and recreational activities can be expected for most of the patients within four to six months of the procedure.