2016-1-1

ABSTRACT

BACK GROUND: The development of new surgical techniques and recent advances in instrumentation in ACL reconstruction has enabled surgeons to achieve better results. However, varying opinion exist among experts with regard to the ideal technique and graft type to be used. Arthroscopic ACL reconstruction using quadrupled semitendinosus tendon autograft with fixation in the femoral tunnel using endobutton and in the tibial tunnel with hybrid fixation using suture disc and anchored with a cancellous screw and washer is a relatively new technique. We have undertaken this study to analyse the postoperative outcome in our experience with this procedure. METHODS: This was a prospective study of patients with ACL injury who underwent Arthroscopic ACL reconstruction using quadrupled semitendinosus 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 (SQ). Functional assessment with hop test was done. RESULTS: 90% of the patients had a favourable outcome as per three scoring systems. All three Scoring systems had a very high correlation as evidenced by the Kendal-tau values ranging from 0.464 to 0.923. Statistically, this was found to be highly significant (p value- 0.000– 0.001). There was good correlation between IKDC and the functional outcome –Pearson’s correlation co- efficient of – 0.192 with IKDC and was statistically significant; p: 0.001 with IKDC. The mean limb symmetry index of hop tests were 83.503 +/- 3.65 [range: 66.36 to 93.33].

CONCLUSION: We conclude that the functional outcome of arthroscopic ACL reconstruction using quadrupled semitendinosus tendon autograft is excellent to good (90%). With proper patient selection and physiotherapy regimen, full occupational and recreational activities can be expected for most of the patients within six months of the procedure.

Key words: ACL (Anterior Cruciate ligament), PCL (Posterior Cruciate Ligament), Hamstring graft, Arthroscopy.

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