title: Intra- and extra-articular anterior cruciate ligament reconstruction utilizing autogeneous semitendinosus and gracilis tendons: 5-year clinical results.
abstract: This prospective study examined 50 patients who underwent ACL surgery using hamstring tendons with a modification including intra- and extra-articular reconstruction. All patients were athletes competing at a high level in various sports. Full return to sports was allowed at 4 months. IKDC score and KT-2000 were used for assessing clinical outcome at a mean of 6.4 years (5-7 years) Resumption of sport, Tegner activity score, and isokinetic test were also used. The IKDC score showed 92% of normal or nearly normal knees. Of the 50 patients 48 regained full extension, and only two had extension deficit between 0 degrees and 3 degrees. KT evaluation was less than 3 mm in 38 cases (76%), 3-5 mm in 9 (18%), and more than 5 mm in 3 (6%). In 90% of cases the patient resumed sport at the same level. The mean Tegner activity score was 8.1 (5-10). The isokinetic test showed no deficit for hamstring and quadriceps muscles. Removal of staples was necessary in eight cases (16%) due to femoral lateral bursitis. Acute reconstruction had significantly better clinical assessment of abnormal laxity and KT value. Men had significantly better results then women. This technique demonstrated a high reliability, low morbidity, low functional deficit and fast recovery using hamstring grafts.
authors.affiliation: Biomechanics Laboratory, Rizzoli Orthopedic Institute, V. Di Barbiano 1/10, 40136 Bologna, Italy.
authors.forename: Maurilio
authors.initials: M
authors.lastname: Marcacci
authors.forename: Stefano
authors.initials: S
authors.lastname: Zaffagnini
authors.forename: Francesco
authors.initials: F
authors.lastname: Iacono
authors.forename: Alberto
authors.initials: A
authors.lastname: Vascellari
authors.forename: Ivano
authors.initials: I
authors.lastname: Loreti
authors.forename: Elisaveta
authors.initials: E
authors.lastname: Kon
authors.forename: Mirco Lo
authors.initials: ML
authors.lastname: Presti
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001265:Athletic Injuries / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D007719:Knee Joint / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D016014:Linear Models; D008297:Male; D010146:Pain / Q000209:etiology; D010292:Paresthesia / Q000209:etiology; D011183:Postoperative Complications; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D012044:Regression Analysis; D012737:Sex Factors; D013710:Tendons / Q000637:transplantation*; D016896:Treatment Outcome