A comparison of the clinical outcome after anterior cruciate ligament reconstruction using a hamstring tendon autograft with special emphasis on the timing of the reconstruction

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2011-03, Vol.19 (3), p.488-494
• Main Authors: Aahlen, Martina, Liden, Mattias
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; adverse effects; Anterior Cruciate Ligament; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries; Articular; Autologous; Cartilage; Chi-Square Distribution; Clinical outcomes; Cohort Studies; Evaluation; Female; Flexibility; Follow-Up Studies; Graft Rejection; Graft Survival; Humans; Injuries; Kirurgi; Knee; Knee Injuries; Knee Injuries - surgery; Ligaments; Male; Medicine; Medicine & Public Health; methods; Muscle; Muscle, Skeletal - surgery; Muscle, Skeletal - transplantation; Nonparametric; Orthopedics; Pain Measurement; Patients; physiology; Range of Motion; Range of Motion, Articular - physiology; Reconstructive Surgical Procedures; Reconstructive Surgical Procedures - adverse effects; Reconstructive Surgical Procedures - methods; Recovery of Function; Rehabilitation; Risk Assessment; scoring; Skeletal; Sports; Statistics; Statistics, Nonparametric; Surgeons; Surgery; Surgical techniques; Sweden; Tendons; Tendons - transplantation; Time Factors; transplantation; Transplantation, Autologous; Trauma; Treatment Outcome; Waiting Lists; Young Adult
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-010-1312-0

Purpose The aim of the study was to compare the results 2 years after anterior cruciate ligament (ACL) reconstruction using a hamstring tendon (HT) autograft in patients operated within 5 months after the injury (Group A) and patients operated more than 24 months after the injury (Group B). Methods Sixty-one patients (27 women, 34 men), with a unilateral ACL rupture, underwent reconstructive surgery using semitendinosus (ST) or semitendinosus and gracilis (ST/G) autografts. Thirty patients (Group A) were operated on within 5 months median 3 (2–5) after the injury, and 31 patients (Group B) were operated on more than 24 months median 30 (24–48) after the injury. The follow-up examination was performed after a median of 25 months (18–43) after the reconstruction. Results A significantly higher Lysholm score was registered in Group A 90 (58–100) than in Group B 81 (38–100), P  = 0.01, as well as a higher Tegner activity level 6 (2–9) versus 5 (0–9), P  = 0.01. The clinical assessments revealed no significant differences between the groups in terms of the one-leg-hop test, KT-1000 arthrometer laxity measurements, manual Lachman test and range of motion (ROM). Furthermore, there was no significant difference between the groups in terms of meniscal and cartilage damage at the index operation. Conclusion At 2 years post-operatively, patients who underwent subacute reconstruction had a significantly better outcome in terms of the Lysholm score and Tegner activity level than patients who underwent delayed reconstruction. The clinical relevance of the present study is that if the patient wishes to continue doing sports on a higher level, subacute reconstruction appears beneficial.