Early functional outcome of Anterior Cruciate Ligament Injuries managed by arthroscopic four strand hamstring autograft: A Prospective study

INTRODUCTION: ACL reconstruction is one of the most common procedures being performed with an estimated 100,000 surgical reconstructions performed annually in United States. During the last 25 years, ACL has been one of the most studied structures in the musculoskeletal system. In recent times awareness of the ACL injuries are far reaching and people of all walks of life seek treatment for ACL deficiency. Indeed, most of our patients are from in and around Chennai with awareness and willingness towards ACL Reconstruction. In our prospective study of 20 cases we have undertaken ACL Reconstruction with the four strand HAMSTRING graft through arthroscopy and assessed its functional outcome using Lysholm knee score4 & IKDC subjective knee evaluation score. AIM OF THE STUDY: The aim of this study is to assess, “The early functional outcome of Anterior Cruciate Ligament Injuries managed by Arthroscopic Four Strand Hamstring Autograft” at Government Royapettah Hospital & Kilpauk Medical College, Chennai from November 2008 to August 2010. MATERIALS AND METHODS: This prospective study is an analysis of 20 cases of anterior cruciate ligament injuries treated arthroscopically with anatomic endoscopic four strand hamstring autograft at the Department of Orthopedic surgery, Government Royapettah Hospital and Kilpauk Medical College, Chennai from November 2008 to October 2009 with a minimum follow up of 4 months and a maximal follow up of 22 months. In our study of 20 patients, 19 were males and one was a female. RESULTS: The outcome of our study was assessed using the Lysholm knee scoring system and IKDC subjective knee evaluation score at the end of final follow up. Lysholm Scale - 10 cases had excellent results(Lysholm scores-94,94,95,95,95,95,99,100,100,100), 5 cases had good results(Lysholm scores-86,89,90,90,90), 3 cases had fair results(Lysholm scores-71,73,79), 2 cases had poor results(Lysholm scores-59,63). IKDC Subjective Knee Evaluation ScorE - Mean score = 88.77 and Range from 74.7 to 98.9 CONCLUSION: ACL reconstruction by using four strand hamstring tendon autograft is highly successful in providing a stable knee with very few complications when proper graft, harvest preparation and anatomical tunnel placement is achieved. Endobutton did not seem to have any superiority of results when compared with the usage of a standard titanium RCI screw. Compaction drilling method when compared to extraction drilling is more advantageous