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Clinical, functional, and isokinetic study of a prospective series of anterior cruciate ligament ligamentoplasty with pedicular hamstrings

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Abstract

Purpose

Few studies describe the specific results of anterior cruciate ligament reconstruction with pedicled hamstring graft (HG). Our goal was to report the isokinetic, clinical, and functional outcomes over the post–operative year following pedicled hamstring ligamentoplasty.

Methods

Twenty-four patients with ACL rupture (mean age 27.4 years) were included prospectively. The technique used a four-stranded HG transplant pedicled to the tibia. The functional result (Lysholm knee score and subjective IKDC score), clinical result (KT-1000, Lachman test, joint amplitudes, objective IKDC score), and isokinetic complication occurrence were analyzed at six months and 12 months follow-up. The functional results, clinical parameters, and complications were analyzed at 30 months follow-up. The comparison of the variables with the various regressions was carried out by a Wilcoxon sign test.

Results

Twenty-one patients were reviewed at six, nine, 12, and 30 months. The mean Lysholm knee score was 90/100 at six months, 96/100 at one year, and 95/100 at 30 months. The mean subjective IKDC score was 77/100 and 89/100 at six and 12 months, and 91/100 at 30 months. The mean difference in laxity compared with the healthy knee was 1.4 mm at six months, 1.9 mm at 12 months, and 2 mm at 30 months. The objective IKDC score was A or B for all patients at 12 and 30 months. The average quadriceps strength deficit decreased from 27 to 16% between six and 12 months post–operative (p = 0.0091) and the average flexor deficit from 23 to 12% (p = 0.0084). No complications were identified.

Conclusion

The abovementioned technique allows reaching functional, clinical, and isokinetic results comparable with the standard techniques while preserving the mechanical and biological interest of tibial insertion.

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Authors and Affiliations

  1. Service de Chirurgie Orthopédique et de Traumatologie du membre inférieur, CHU Hautepierre 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 avenue Molière, 67098, Strasbourg Cedex, France

    David Bahlau, Henri Favreau, David Eichler, François Bonnomet & Matthieu Ehlinger

  2. Département de Chirurgie Orthopédique, Centre Albert-Trillat, Hôpital de la Croix-Rousse, 103 boulevard de la Croix-Rousse, 69004, Lyon, France

    Sébastien Lustig

  3. Laboratoire ICube, CNRS UMR 7357, 30 Bd Sébastien Brant, 67400, Illkirch, France

    Matthieu Ehlinger

Authors
  1. David Bahlau
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  2. Henri Favreau
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  3. David Eichler
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  4. Sébastien Lustig
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  5. François Bonnomet
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  6. Matthieu Ehlinger
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Corresponding author

Correspondence to Matthieu Ehlinger.

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Conflict of interest

David Bahlau, David Eichler, and Henri Favreau declare no conflict of interest. Sébastien Lustig was supported by institutional support Amplitude®, Corin®, Consulting activity Medacta®, Smith nephew®, Groupe Lépine®. François Bonnomet had consulting activity for Serf®, Amplitude®. Matthieu Ehlinger had consulting activity for Depuy-Synthes®, Newclip Technics®, Groupe Lépine®, Amplitude®, associated redactor for SOFCOT instructional lecture.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Level of evidence: Prospective study, level II.

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Bahlau, D., Favreau, H., Eichler, D. et al. Clinical, functional, and isokinetic study of a prospective series of anterior cruciate ligament ligamentoplasty with pedicular hamstrings. International Orthopaedics (SICOT) 43, 2557–2562 (2019). https://doi.org/10.1007/s00264-019-04392-0

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  • DOI: https://doi.org/10.1007/s00264-019-04392-0

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