[Double-bundle reconstruction of anterior cruciate ligament using hamstring auto graft under arthroscopy].

OBJECTIVE

To evaluate the clinical effects of double-bundle reconstruction of anterior cruciate ligament (ACL) using hamstring tendon auto graft under arthroscopy.

METHODS

From April 2009 to March 2010, 25 patients (13 males and 12 females) with ACL deficiency were treated with arthroscopy, ranging in age from 17 to 43 years, with an average of 25.8 years. There were 17 patients caused by sports injuries, 6 patients caused by accidental falling, and 2 patients caused by traffic injury. The average duration of the disease was 3 months. The main symptom was knee instability in 8 patients, and knee pain and swelling in other patients. Pivot shift test was positive in 15 cases, and Lachman test was positive in 25 cases, the ADT (anterior drawer test) was positive in 25 cases. The anterior transition of the tibia measured by KT2000 instrument was (7.1 +/- 2.4) mm more than the contralateral knee. The average Lysholm score was 40.0 +/- 5.4. The Tegner activity scores averaged 3.2 +/- 0.7. The double tibial tunnels and double femoral tunnels were drilled on the footprint of the ACL to reconstruct the anteromedial and posterolateral bundles under arthroscopy. Tendons were fixed with Endo-buttons at the femoral side and with biodegradable interference screw at the tibial side. Postoperative symptoms and signs were observed during follow-up period. The anterior transition of the tibia was measured by KT2000, and the Lysholm score and Tegner scores were used for evaluating knee function. Statistically analyzed was performed with SPSS 15.0.

RESULTS

All the patients were followed up, and the duration ranged from 24 to 35 months (averaged, 27 months). At the latest follow-up, there was no positive pivot shift, while the Lachman test and ADT were negative or positive of grade I. The average Lysholm score of the 25 cases was 40.0 +/- 5.4 before operation, and 85.0 +/- 4.5 at the latest follow-up, 3.2 +/- 0.7 before operation and 7.5 +/- 0.2 at the latest follow-up for Tegner activity score. Statistically, the difference between preoperative score and the postoperative score was significant.

CONCLUSION

Double-bundle reconstruction of ACL with hamstring tauto graft under arthroscopy is effective and reliable to restore the stability of the knee, and the clinical effect is good to excellent.