Skip to main content

Advertisement

SpringerLink
Log in

Anterior cruciate ligament reconstruction using hamstring tendon graft without detachment of the tibial insertion

  • Technical Report
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction: We report results of the anterior cruciate ligament reconstruction using a four-strand hamstring graft without detachment of the tibial insertion of the tendons. Material and Methods: In 74 patients the hamstring graft was fixed using an endobutton on the femoral side and a barbed staple on the tibial side. There were 69 male and 5 female patients. The mean age at the time of operation was 35.1 years (21–53 years). Postoperatively, an accelerated rehabilitation was followed with no protective braces. The mean follow-up period was 64 months (range 48 to 84 months). Results: All patients achieved full range of motion with a stable knee joint. The mean side-to-side difference using KT-1000 was 1.43 mm (SD 3.86). The average Lysholm score improved from 42 to 79.2 and the Tegner score improved from 3.4 to 5.9. Conclusion: Detachment of hamstring tendons from their tibial insertion is unnecessary and our results with accelerated rehabilitation without protective braces are satisfactory and comparable to other studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.

Similar content being viewed by others

References

  1. Aglietti P, Buzzi R, Zaccherotti G, De Biase P (1994) Patellar tendon versus semitendinosus and gracilis in ACL reconstruction. Am J Sports Med 22:211–218

    PubMed  CAS  Google Scholar 

  2. Beard DJ, Anderson JL, Davies S, Price AJ, Dodd CAF (2001) Hamstrings vs. patella tendon for anterior cruciate ligament reconstruction: a randomised controlled trial. Knee 8:45–50

    Article  PubMed  CAS  Google Scholar 

  3. Benson ER, Barnett PR (1998) A delayed transverse avulsion fracture of the superior pole of the patella after anterior cruciate ligament reconstruction. Arthroscopy 14:85–88

    Article  PubMed  CAS  Google Scholar 

  4. Bonamo J, Krinick R, Sporn A (1984) Rupture of the patellar ligament after use of its central third for anterior cruciate reconstruction. J Bone Joint Surg [Am] 66:1294–1297

    CAS  Google Scholar 

  5. Brown CH, Sklar JH (1998) Endoscopic anterior cruciate ligament reconstruction using quadrupled hamstring tendons and endobutton femoral fixation. Techniques Orthop 13:281–298

    Google Scholar 

  6. Corry IS, Webb JM, Clingeleffer AJ, Pinczewski LA (1999) Arthroscopic reconstruction of the anterior cruciate ligament: a comparison of patellar tendon autograft and four-strand hamstring tendon autograft. Am J Sports Med 27:444–454

    PubMed  CAS  Google Scholar 

  7. Freedman KB, D’Amato MJ, Nedeff DD, Kaz A, Bach BR Jr (2003) Arthroscopic anterior cruciate ligament reconstruction: a metaanalysis comparing patellar tendon and hamstring tendon autografts. Am J Sports Med 31:2–11

    PubMed  Google Scholar 

  8. Gerich TG, Cassim A, Lattermann C et al (1997) Pull out strength of tibial graft fixation in anterior cruciate ligament replacement with a patellar tendon graft. Interference screw versus staple fixation in human knees. Knee Surg Sports Traumatol Arthroscopy 5:84–89

    Article  CAS  Google Scholar 

  9. Hamner DL, Brown CH, Steiner ME, Hecker AT, Hayes WC (1999) Hamstring tendon grafts for reconstruction of the anterior cruciate ligament. Biomechanical evaluation of the use of multiple strands and tensioning techniques. J Bone Joint Surg [Am] 81:549–557

    CAS  Google Scholar 

  10. Jomha NM, Raso VJ, Leung P (1993) Effect of varying angles on the pull out strength of interference screw fixation. Arthroscopy 9:580–583

    Article  PubMed  CAS  Google Scholar 

  11. Kurosaka M, Yashiya S, Andrish JT (1987) A biomechanical comparison of different surgical techniques of graft fixation in anterior cruciate ligament reconstruction. Am J Sports Med 15:225–229

    PubMed  CAS  Google Scholar 

  12. Kurzweil PR, Frogameni AD, Jackson DW (1995) Tibial interference screw removal following anterior cruciate ligament reconstruction. Arthroscopy 11:289–291

    Article  PubMed  CAS  Google Scholar 

  13. Marder RA, Raskind JR, Carroll M (1991) Prospective evaluation of arthroscopically assisted anterior cruciate ligament reconstruction. Patellar tendon versus semitendinosus and gracilis tendons. Am J Sports Med 19:478–484

    PubMed  CAS  Google Scholar 

  14. Mathews LS, Soffer SR (1989) Pitfalls in the use of interference screws for anterior cruciate ligament reconstruction: brief report. Arthroscopy 5:225–226

    Article  Google Scholar 

  15. Noyes FR, Butler DL, Paulos LE, Grood ES (1983) Intra-articular cruciate reconstruction: perspectives on graft strength, vascularisation and immediate motion after replacement. Clin Orth 172:71–77

    Google Scholar 

  16. Noyes FR, Butler DL, Grood ES, Zernicke RF, Hefzy MS (1984) Biomechanical analysis of human ligament grafts used in knee-ligament repairs and reconstruction. J Bone Joint Surg [Am] 66:344–352

    CAS  Google Scholar 

  17. O’Brien SJ, Warren RF, Pavlov H, Panariello R, Wickiewicz TL (1991) Reconstruction of the chronically insufficient anterior cruciate ligament with the central third patellar ligament. J Bone Joint Surg [Am] 73:278–286

    CAS  Google Scholar 

  18. O’Neill DB (1996) Arthroscopically assisted reconstruction of the anterior cruciate ligament: A prospective randomised analysis of three techniques. J Bone Joint Surg [Am] 78:803–813

    CAS  Google Scholar 

  19. Paulos LE, Rosenberg TD, Drawbert J, Manning J, Abbott P (1987) Infrapatellar contracture syndrome. An unrecognised cause of knee stiffness with patella entrapment and patella infera. Am J Sports Med 15:331–341

    PubMed  CAS  Google Scholar 

  20. Rodeo SA, Arnoczky SP, Torzilli PA, Hidaka C, Warren RF (1993) Tendon-healing in a bone tunnel. A biomechanical and histological study in the dog J Bone Joint Surg [Am] 75:1795–1803

    CAS  Google Scholar 

  21. Rosenberg TD, Franklin JL, Baldwin GN, Nelson KA (1992) Extensor mechanism function after patellar tendon graft harvest for anterior cruciate ligament reconstruction. Am J Sports Med 20:519–526

    PubMed  CAS  Google Scholar 

  22. Rowden NJ, Sher D, Rogers GJ, Schindhelm K (1997) Anterior cruciate ligament graft fixation: initial comparison of patellar tendon and semiteninosus autografts in young fresh cadavers. Am J Sports Med 25:472–478

    PubMed  CAS  Google Scholar 

  23. Shelbourne KD, Gray T (1997) Anterior cruciate ligament reconstruction with autogenous patellar tendon graft followed by accelerated rehabilitation. A two to nine year follow up. Am J Sports Med 25:786–795

    PubMed  CAS  Google Scholar 

  24. Shelbourne KD, Nitz P (1990) Accelerated rehabilitation after anterior cruciate ligament reconstruction. Am J Sports Med 18:292–299

    PubMed  CAS  Google Scholar 

  25. Shino K, Nakagawa S, Inoue M, Horibe S, Yoneda M (1993) Deterioration of patellofemoral articular surfaces after anterior cruciate ligament reconstruction. Am J Sports Med 21:206–211

    PubMed  CAS  Google Scholar 

  26. Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop 198:43–49

    PubMed  Google Scholar 

  27. Yasuda K, Tsujino J, Ohkoshi Y, Tanabe Y, Kaneda K (1995) Graft site morbidity with autogenous semitendinosus and gracilis tendons. Am J Sports Med 23:706–714

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Corbett Hospital, Stourbridge, West Midlands, UK

    M. Salman Ali, A. Kumar, S. Adnaan Ali & T. Hislop

  2. 170, Woodhouse Lane, Sale, M33 4LN, Cheshire, UK

    A. Kumar

Authors
  1. M. Salman Ali
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Adnaan Ali
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. Hislop
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Kumar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Salman Ali, M., Kumar, A., Adnaan Ali, S. et al. Anterior cruciate ligament reconstruction using hamstring tendon graft without detachment of the tibial insertion. Arch Orthop Trauma Surg 126, 644–648 (2006). https://doi.org/10.1007/s00402-006-0128-3

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-006-0128-3

Keywords

Search

Navigation