This article is more than 5 years old. Information may no longer be current.
Better outcomes found with double-strand vs single-strand hamstrings graft ACL reconstruction
Click Here to Manage Email Alerts
At long-term follow-up, non-anatomical ACL reconstruction with an over-the-top technique offered satisfactory results for control of static and dynamic instability, with better subjective and functional outcomes and fewer degenerative changes observed with use of double-strand vs. single-strand hamstrings graft.
Researchers retrospectively reviewed 51 patients involved in sports who underwent non-anatomical ACL reconstruction with an over-the-top femoral passage approach: 24 patients underwent single-strand hamstrings graft (1SHG) reconstruction and 31 underwent double-strand graft (2SHG) reconstruction. At 2 weeks postoperatively, patients were allowed full weight bearing without braces. At 3 weeks to 5 weeks, patients performed closed-chain kinetic exercises, followed by open-chain kinetic exercises at 5 weeks to 9 weeks. The patients were allowed to run at 3 months, and by 6 months, the patients were permitted to return to sports.
The researchers reviewed the patients’ preoperative evaluation data, including complete history and radiographic examination data, to confirm the presence of ACL lesions and assess the potential for associated lesions. IKDC, KOOS and Tegner scores, which were recorded preoperatively and at a mean of 12.1 years postoperatively, were reviewed.
Results showed no intraoperative or immediate postoperative complications. Mean IKDC scores the final-follow-up for 1SHG and 2SHG were 76.6 and 88.9, respectively. Mean KOOS score in the 1SHG group was 82.6, compared with 92.4 in the 2SHG group, which indicated that the 2SHG group had statistically significantly better IKDC and KOOS scores compared with the 1SHG group, according to the researchers.
Preoperative Tegner score for the 1SHG group was 6.95, compared with 6.1 at the final follow-up. For the 2SHG group, the preoperative score was 7.26, compared with 6.97 at the final follow-up.
No differences were observed in ligamentous and instability between groups regarding the Lachman test and arthometric evaluation, according to the researchers. Additionally, results from the pivot shift test showed the patients in the 1SHG group had significantly higher incidences of rotational instability.
At final follow-up, six 1SHG patients returned to sports at their preinjury level, 10 patients returned at a lower level and four patients gave up. In the 2SHG group, 24 patients returned to sports at their preinjury level, four patients returned at a lower level and three gave up.
Through patients’ radiographs, the researchers found the 1SHG group had significantly higher arthritis occurrences in medial and lateral compartments vs. 2SHG group. – by Monica Jaramillo
Disclosures: Ruffilli reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
Collapse
Ruffilli A, et al. Orthopedics. 2015;doi:10.3928/01477447-20150701-64.
Click Here to Manage Email Alerts