Chronic anterior cruciate ligament insufficiency results in inferior quality hamstring autografts

Background Availability of a good quality autograft of adequate length is the first step towards a successful knee ligament reconstruction. Being able to predict the quality and length of hamstring autograft can go a long way in making the surgeon’s pre-operative planning a lot easier. The purpose o...

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Bibliographic Details
Published in:European journal of orthopaedic surgery & traumatology 2019-10, Vol.29 (7), p.1481-1484
Main Authors: Naik, Arjun, Acharya, Prashant
Format: Article
Language:English
Subjects:
Acute Disease
Adolescent
Adult
Anterior Cruciate Ligament Injuries - surgery
Autografts - pathology
Chronic Disease
Female
Hamstring Muscles
Hospitals
Humans
Joint Instability - etiology
Knee
Ligaments
Ligaments - pathology
Ligaments - transplantation
Male
Medicine
Medicine & Public Health
Original Article • KNEE - LIGAMENTS
Patients
Quality
Surgeons
Surgery
Surgical Orthopedics
Tissue and Organ Harvesting
Traumatic Surgery
Young Adult
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Summary:Background Availability of a good quality autograft of adequate length is the first step towards a successful knee ligament reconstruction. Being able to predict the quality and length of hamstring autograft can go a long way in making the surgeon’s pre-operative planning a lot easier. The purpose of this study was to find out if any correlation existed between the duration of ACL injury with history of repeated instability episodes and the quality and length of Hamstring graft that was harvested. Methods Forty consecutive patients who underwent ACL reconstruction using quadrupled Hamstring tendon graft were evaluated with regard to the duration of injury, number of instability episodes and graft characteristics like difficulty in harvesting the graft, quality and length of the graft. Results We found a statistically significant difference between the usable length of harvested Hamstring tendon in patients with acute and chronic injury ( p  = 0.004). There was a significantly high risk of the graft being shorter and of poor quality in patients with chronic injury (odds ratio = 5.7). Conclusion Chronicity of ACL injury with repeated strains can cause fibrosis at the musculotendinous junction and result in harvest of a poor quality and short hamstring autograft. A detailed history with regard to duration of injury and repeated instability episodes will help a surgeon plan better when anticipating a sub-optimal graft.
ISSN:1633-8065
1432-1068
DOI:10.1007/s00590-019-02467-7