Assessment of the functional outcome of Arthroscopic Reconstruction of Anterior Cruciate Ligament using Hamstring Tendon Autograft

Venkateswaran, S R (2017) Assessment of the functional outcome of Arthroscopic Reconstruction of Anterior Cruciate Ligament using Hamstring Tendon Autograft. Masters thesis, Stanley Medical College, Chennai.

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Abstract

INTRODUCTION: Knee injuries are increasing and becoming more common due to the exponential rise in road traffic accidents and sports related activities by common people. In current scenario, knee injuries take the Orthopaedician to a plethora of diagnostic and management challenges which is not resolved even by modern understanding and technical improvements in science. Anterior cruciate ligament is one amongst the most common injured structure around knee. Being one of the prime stabilizers of the knee, the major role of Anterior cruciate ligament is to resist anterior translation of the tibia on the femur. ACL also contributes to stabilize the knee against varus and valgus stress, excessive hyperextension and proprioception. As ACL doesn’t heal with repair, reconstruction is the only possibility. Anterior cruciate ligament reconstruction is done to improve stability of the knee joint, to prevent later meniscal tear and to delay the onset of early osteoarthritis. Graft tissue selection, graft placement, methods of graft fixation, variations in the rehabilitation protocol, post reconstruction functional bracing, and criteria for return to routine activities remains controversial. As the open ACL reconstruction has prolonged rehabilitation and more complications, arthroscopic assisted ACL reconstruction is a boon for such injuries where precision and rehabilitation is quick. Since early return to daily routine with full range of movements and minimal donor site morbidities is feasible following arthroscopic reconstruction of ACL, it is considered more superior to the extraarticular and intraarticular reconstruction by open arthrotomy. OBJECTIVE: The aim of this study is to assess the functional outcome of Arthroscopic Reconstruction of Anterior Cruciate Ligament using hamstring tendon autograft. MATERIALS AND METHODS: This is a study done on 20 patients presenting with knee instability, who were clinically examined and confirmed by MRI for ACL insufficiency and treated with arthroscopic reconstruction of ACL with hamstring tendon autograft between July 2015 and July 2016 at Government Stanley Hospital, Chennai. Patients were followed up at 4 weeks, 3 months, 6 months and once in every 6 months thereafter. All patients were evaluated and graded with International Knee Documentation Committee (IKDC) examination form. RESULTS: ACL injury more commonly occurs in males in the younger age group (20-30 years). The most common mode of injury is Road traffic accident followed by sports. Out of 20 patients, 15 patients had a normal knee (IKDC Grade A), 4 patients had a nearly normal knee (IKDC Grade B) and one patient ended up with abnormal knee (IKDC Grade C). Two patients with Anterior cruciate ligament injury presenting more than three years since initial trauma ended up with osteoarthritis changes in the knee. CONCLUSION: The arthroscopic technique of hamstring tendon autograft for ACL reconstruction using the endobutton for femoral fixation and interference screw for tibial fixation has low morbidity and excellent functional results. Proper surgical technique, adequate graft fixation and good post-operative rehabilitation warrants excellent functional results with Arthroscopic ACL reconstruction using hamstring tendon autograft.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Anterior Cruciate Ligament, Reconstruction, arthroscopic, Hamstring, Endobutton, Interference screw, IKDC, Functional outcome.
Subjects: MEDICAL > Orthopaedics
Depositing User: Devi S
Date Deposited: 19 Mar 2020 06:33
Last Modified: 19 Mar 2020 06:33
URI: http://repository-tnmgrmu.ac.in/id/eprint/12348

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