title: Stability results of hamstring anterior cruciate ligament reconstruction at 2- to 8-year follow-up.
abstract: OBJECTIVE
  The purpose of this study was to test the hypothesis that hamstring (HS) anterior cruciate ligament (ACL) reconstructions using EndoButton (Smith & Nephew, Andover, MA) femoral and whipstitch/screw tibial fixation can produce a high rate of objective stability in a population of reconstructed patients with low morbidity.
  
  
  METHODS
  Case series.
  
  
  METHODS
  We retrospectively reviewed 153 consecutive primary HS ACL reconstructions in skeletally mature patients without other ligament reconstructions. All knees had EndoButton femoral and whipstitch/screw tibial fixation; 139 patients were located and 133 were tested. Thirteen were geographically distant and tested subjectively only. Evaluations included KT-1000 testing; radiographs; and Noyes, Lysholm, and Single Assessment Numeric Evaluation (SANE) ratings. Follow-up was 24 to 104 months (mean, 54.4 months).
  
  
  RESULTS
  There were no graft failures. No patient had rupture of an implanted graft. No patient had repeat surgery for instability; 96.9% of reconstructions had maximum manual side-to-side differences of < or =3 mm, 85.7% had < or =2 mm; 3% of the knees had a 4-mm difference; none had > or =5-mm difference. There was no objective stability difference between male and female patients and no deterioration in results with increasing follow-up time. Median ratings were: Noyes, 94; Lysholm, 94.5; and SANE, 90. Radiographs showed that no EndoButtons had migrated. No EndoButton or tibial screw had to be removed due to symptoms from the implant. One hundred eighteen of 120 patients had full extension; the other 2 patients had a 2 degrees flexion loss. One patient required repeat arthroscopy for arthrofibrosis but had full range of motion at follow-up. There were no deep knee infections. One patient had a superficial wound infection requiring intravenous antibiotics. One patient had a calf deep vein thrombosis that resolved with treatment.
  
  
  CONCLUSIONS
  Hamstring ACL reconstructions can produce (1) reliable, durable stability in both males and females with no graft failures, (2) good clinical ratings, (3) excellent range of motion, and (4) low morbidity, without hardware problems.
  
  
  METHODS
  Level IV, Case Series.
authors.affiliation: Illinois Sports Medicine & Orthopaedic Centers, Glenview, Illinois 60025, USA. research@ismoc.net
authors.forename: Chadwick C
authors.initials: CC
authors.lastname: Prodromos
authors.forename: Yung S
authors.initials: YS
authors.lastname: Han
authors.forename: Brett L
authors.initials: BL
authors.lastname: Keller
authors.forename: Richelle J
authors.initials: RJ
authors.lastname: Bolyard
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001863:Bone Screws; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000209:etiology; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery; D008297:Male; D018482:Muscle, Skeletal / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications; D019736:Prostheses and Implants; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013536:Suture Techniques; D013710:Tendons / Q000637:transplantation*; D016896:Treatment Outcome