Hamstring harvest for ACL reconstruction: Is there a disadvantage?
|IJOCP | Volume – 2015| Issue – 2015| Article ID – 2015:92
Conference: Indian Orthopaedic Association Annual Conference IOACON-2013, India [Click for Full details]
Authors: Gupta G, Engstrom B, Kaushik D, Ratan B, Dayma
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Purpose: To study the effect of hamstring harvest on knee flexor function in anterior cruciate ligament (ACL) reconstructed patients.
Methods: An evaluation of prospectively collected data was done for 943 patients that underwent arthroscopic ACL reconstruction. They formed 3 groups: Bone patellar tendon bone graft (BPTB; 167 patients), semitendinosus graft (ST; 170 patients), semitendinosus & gracilis graft (STG; 606 patients). After a mean 6.3 months follow up, the 3 groups were assessed for peak torque, angle of peak torque and Total work during concentric flexor contraction at 90°/sec. Functional assessment was done by KOOS, Tegner activity scale, ROM and One leg hop.
Results: Peak torque was 88% of the healthy knee in ST and STG groups, 98% in BPTB group. Angle of peak torque had shifted from 32.5° to 25.7° (p<0.0001) in ST, from 31.5° to 25.3° (p<0.0001) in STG and 29.7° to 27.8° (not significant) in BPTB group. The total work was 87% of the healthy knee in ST, 85% in STG and 98% in BPTB group. Functionally, the hamstring groups showed better outcome on one leg hop and KOOS subscales of pain, ADL, function in sport/recreation and knee related quality of life. There was no difference between three groups on KOOS symptoms subscale, Tegner activity scale and ROM in extension. BPTB group regained better terminal flexion than hamstrings. Isokinetic and functional tests demonstrated no difference between the ST vs STG group.
Conclusions: The hamstrings recovered to near 90% peak torque. This recovery is at a shallow angle of flexion leading to a better agonist and thus benefitting the reconstructed ACL. Functional outcomes also establish hamstrings as a good graft. There was no difference between the ST and STG groups on isokinetic or functional assessment. Level of Evidence:IV
|How to Cite this Abstract|
|Gupta G, Engstrom B, Kaushik D, Ratan B, Dayma . Hamstring harvest for ACL reconstruction: Is there a disadvantage?. International Journal of Conference Proceedings 2015;(2015):92|