Clinical Outcome of Anatomical Transportal Arthroscopic Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autograft.

Background: Good clinical outcome and return to sport and daily functions after anatomical arthroscopic anterior cruciate ligament (ACL) reconstruction is goal standard in this surgery. but to date, there are different challenging issues between orthopedic surgeons regarding graft selection and surgical techniques.

Methods: We retrospectively reviewed the patients who underwent anatomical arthroscopic one bundle ACL reconstruction with quadruple hamstring tendon autograft from 2010 to 2016 in our orthopedic sport medicine center. Eighty-two eligible patients (82 knees) who had met our inclusion criteria were examined in terms of knee stability by clinical examinations and KT 2000 arthrometer and - also were evaluated regarding variables related to their health and knee status with a mean 48months follow-up.

Results: Seventy-seven patients (93.9%) were male and the other 5 cases (6.1%) were female. The mean age was 33 ± 8.06 years old at the time of surgery and mean BMI amount was 26.81 ± 3.72. 78 patients (95%) returned to pre-injury sport activity level after ACL reconstruction and two patients (2.4%) had re-rupture. 63 patients (76.8%) had negative anterior drawer and 67patients (81.8%) negative lachman tests respectively. 10 patients (13%) were found to have positive pivot shift tests which was correlated with pain and a less KOOS scores with a significant difference ( P= 0.03 ). 72 patients (87%) had negative tests in active and 70 (85.4%) had less than 3 mm side to side difference in manual testing by KT2000. Final KOOS score was 70.87 ± 19.76. Mean Lysholm score was 90 ± 4.77. Mean International Knee Documentation Committee (IKDC) score of this study was 85 ± 14.11.Patients who had concomitant partial meniscectomy had significantly lower IKDC scores ( P<0.01 ).Mean kujala score was 79 ± 3.07.

Conclusion: The use of quadrupled hamstring tendon autograft besides the most important part of the treatment which is the surgical technique would yield to excellent results in ACL reconstruction both subjectively and objectively. In addition, patient selection and surgeon's experience should be considered in determining the treatment plan for the patients. Level of evidence: IV.