Arjun Naik1, Prashant Acharya2. 1. Spire Alexandra Hospital, Kent, UK. drarjunnaik@gmail.com. 2. Father Muller Medical College Hospital, Mangalore, India.
Abstract
BACKGROUND: Availability of a good quality autograft of adequate length is the first step towards a successful knee ligament reconstruction. Being able to predict the quality and length of hamstring autograft can go a long way in making the surgeon's pre-operative planning a lot easier. The purpose of this study was to find out if any correlation existed between the duration of ACL injury with history of repeated instability episodes and the quality and length of Hamstring graft that was harvested. METHODS: Forty consecutive patients who underwent ACL reconstruction using quadrupled Hamstring tendon graft were evaluated with regard to the duration of injury, number of instability episodes and graft characteristics like difficulty in harvesting the graft, quality and length of the graft. RESULTS: We found a statistically significant difference between the usable length of harvested Hamstring tendon in patients with acute and chronic injury (p = 0.004). There was a significantly high risk of the graft being shorter and of poor quality in patients with chronic injury (odds ratio = 5.7). CONCLUSION: Chronicity of ACL injury with repeated strains can cause fibrosis at the musculotendinous junction and result in harvest of a poor quality and short hamstring autograft. A detailed history with regard to duration of injury and repeated instability episodes will help a surgeon plan better when anticipating a sub-optimal graft.
BACKGROUND: Availability of a good quality autograft of adequate length is the first step towards a successful knee ligament reconstruction. Being able to predict the quality and length of hamstring autograft can go a long way in making the surgeon's pre-operative planning a lot easier. The purpose of this study was to find out if any correlation existed between the duration of ACL injury with history of repeated instability episodes and the quality and length of Hamstring graft that was harvested. METHODS: Forty consecutive patients who underwent ACL reconstruction using quadrupled Hamstring tendon graft were evaluated with regard to the duration of injury, number of instability episodes and graft characteristics like difficulty in harvesting the graft, quality and length of the graft. RESULTS: We found a statistically significant difference between the usable length of harvested Hamstring tendon in patients with acute and chronic injury (p = 0.004). There was a significantly high risk of the graft being shorter and of poor quality in patients with chronic injury (odds ratio = 5.7). CONCLUSION: Chronicity of ACL injury with repeated strains can cause fibrosis at the musculotendinous junction and result in harvest of a poor quality and short hamstring autograft. A detailed history with regard to duration of injury and repeated instability episodes will help a surgeon plan better when anticipating a sub-optimal graft.
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Authors: Rob P A Janssen; Maria J F van der Velden; Marijn van den Besselaar; Max Reijman Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-06-28 Impact factor: 4.342
Authors: Stergios G Papastergiou; Papastergiou G Stergios; Georgios A Konstantinidis; Konstantinidis A Georgios; Konstantinos Natsis; Natsis Konstantinos; Efthymia Papathanasiou; Papathanasiou Efthymia; Nikolaos Koukoulias; Koukoulias Nikolaos; Alexandros G Papadopoulos; Papadopoulos G Alexandros Journal: Anat Res Int Date: 2012-07-29