Immediate post-operative pain in anterior cruciate ligament reconstruction surgery with bone patellar tendon bone graft versus hamstring graft.
BACKGROUND
Pain in the immediate post-operative period after anterior cruciate ligament (ACL) surgery, apart from an unpleasant experience for the patient, can act as a barrier for static quadriceps contractions and optimum execution of the initial rehabilitation protocol resulting in slow recovery and a later return to full function for a sportsperson. There is no report in the literature comparing pain in the immediate post-operative period after using the two most widely used autografts, bone patellar tendon bone (BPTB) graft and hamstring graft.


METHODS
The present study compared the visual analogue scale (VAS) pain score in the immediate post-operative period after arthroscopic ACL reconstruction with the BPTB and hamstring autografts. Both groups consisted of 50 patients each. The mean age of the BPTB and hamstring cohorts was 26.9 ± 7.3 years (age range 18-59 years) and 26.7 ± 9.0 years (age range 17-52 years), respectively. Unpaired t test was applied to compare pain scores between the BPTB and hamstring cohorts.


RESULTS
In the present study, patients in the BPTB cohort showed higher mean pain scores across all the post-operative time intervals except at 6 h. However, the difference in the mean VAS pain score at post-operative 6, 12,18, 24, 36 and 48 h in the two groups was statistically not significant (p value of 1, 0.665, 0.798, 0.377, 0.651 and 0.215 at 6, 12, 18, 24, 36 and 48 h, respectively).


CONCLUSIONS
Our study concludes that the arthroscopic ACL reconstruction with BPTB autograft and hamstring autograft is associated with similar pain in the immediate post-operative period. As a result, aggressive physiotherapy regime is not affected by the type of graft being used for ACL reconstruction, as the pain scores in the immediate post-operative period are similar for both techniques.


BACKGROUND
Clinical Trials Registry-India, CTRI/2016/01/006502.
Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India. ravikgupta2000@yahoo.com.
Ravi
R
Gupta
Department of Anaesthesia, Government Medical College and Hospital, Chandigarh, India.
Dheeraj
D
Kapoor
Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.
Love
L
Kapoor
Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.
Anubhav
A
Malhotra
Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.
Gladson David
GD
Masih
Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.
Anil
A
Kapoor
Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.
Shweta
S
Joshi
D000293:Adolescent; D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000175:diagnosis / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000009:adverse effects*; D064594:Bone-Patellar Tendon-Bone Grafts / Q000637:transplantation*; D005260:Female; D005500:Follow-Up Studies; D000070633:Hamstring Muscles / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology*; D011446:Prospective Studies; D014182:Transplantation, Autologous; D055815:Young Adult
ACL surgery; BPTB graft; Hamstring graft; Immediate post-operative; Pain score