Morbidity Following Anterior Cruciate Ligament Reconstruction Using Hamstring Autograft

ABSTRACT

Introduction: As anterior cruciate ligament (ACL) reconstruction becomes more frequently performed, the expectation of earlier return to activities becomes higher; hence graft selection becomes more important. The use of hamstring tendon autograft is perceived to have less postoperative morbidities. We evaluate the early postoperative complications in this prospective study.

Materials and Methods: Seventy-six patients operated by the same surgeon were assessed preoperatively, and 3 and 6 months after surgery. The hamstring and quadriceps strength were measured with Biodex machine and the side-to-side laxity measured using KT-1000 instrument. The patients were also assessed for their subjective complaints using IKDC (International Knee Documentation Committee) Knee Scoring System.

Results: The strength and endurance index of the quadriceps and hamstrings recovered and improved by the sixth month after surgery. The recovery by the quadriceps muscle is more marked and by the sixth month, it has recovered to more than the preoperative level. As for laxity, the average side-to-side difference at 30 pounds was 2.75 mm by 6 months. Of these patients, the side-to-side difference was less than 5 mm in 66 patients (5 mm as taken to be acceptable for graft success). As for IKDC rating, at the sixth month, 71 patients had normal or near normal knee by their own assessment. No patients had anterior knee pain at rest. Sensory deficits were only present in 3 patients with complaints of numbness over the distribution of the saphenous nerve or its infrapatellar branch.

Conclusion: Most morbidities are temporal in nature and do not significantly affect the patient’s activities.

---