Functional Outcome of Arthroscopic Reconstruction of Single Bundle Anterior Cruciate Ligament with 5 Strand Hamstring Autograft

Background: Patellofemoral problems are not uncommon among post-anterior cruciate ligament (ACL) reconstruction patients. Hamstring autograft harvesting-related factor is one of the suspected causes. A lack of tibiofemoral internal rotation force due to strength deficit causes the patella tends to shift laterally. Purposes: Peroneus longus tendon has been proposed as an alternative graft source due to its adequate tensile strength and minimal donor site morbidity to the knee biomechanics, including the patellofemoral joint. This tendon does not cross the knee joint and thus does not affect patellofemoral alignment and biomechanics. This study aims to compare patellofemoral problems between hamstring and peroneus longus autograft harvested-patients following ACL reconstruction. Material and methods: Thirty-one subjects who underwent primary single-bundle ACL reconstruction between September 2018 and September 2019 and met the inclusion criteria were grouped into the hamstring group (n=16) and peroneus longus group (n=15). Both groups were evaluated retrospectively. The follow-up assessment was conducted on the phase II rehabilitation program. The assessed variables were pain, crepitus, and the Indonesian-validated Kujala score. Results: No significant differences in pain and crepitus were found between both groups. There were significant differences in the Kujala score between both groups (P < .001). The peroneus longus group reported an averagely higher score than the hamstring group. Conclusion: Single bundle ACL reconstruction using peroneus longus tendon autograft produces less patellofemoral symptoms and functional limitation than using hamstring tendon autograft.

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Standard Anterior Cruciate Ligament Reconstruction Versus Isolated Single-Bundle Augmentation with Hamstring Autograft

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2009.05.020 ◽

2009 ◽

Vol 25 (11) ◽

pp. 1265-1274 ◽

Cited By ~ 43

Author(s):

Kyoung Ho Yoon ◽

Dae Kyung Bae ◽

Seung Mok Cho ◽

Soo Yeon Park ◽

Jung Hwan Lee

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Single Bundle ◽

Hamstring Autograft ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate

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Single-bundle versus double-bundle arthroscopic reconstruction of the anterior cruciate ligament: what does the available evidence suggest?

Journal of Orthopaedics and Traumatology ◽

10.1007/s10195-007-0171-z ◽

2007 ◽

Vol 8 (2) ◽

pp. 95-100 ◽

Cited By ~ 6

Author(s):

V. Calvisi ◽

S. Lupparelli ◽

G. Rinonapoli ◽

R. Padua

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Double Bundle ◽

Single Bundle ◽

Arthroscopic Reconstruction ◽

Bundle Versus ◽

Anterior Cruciate

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Screw and Sheath Tibial Fixation Associated With a Higher Likelihood of Deep Infection After Hamstring Graft Anterior Cruciate Ligament Reconstruction

The American Journal of Sports Medicine ◽

10.1177/0363546520902716 ◽

2020 ◽

Vol 48 (4) ◽

pp. 806-811

Author(s):

Andrew P. Hurvitz ◽

Heather A. Prentice ◽

Tadashi T. Funahashi ◽

Gregory B. Maletis

Keyword(s):

Anterior Cruciate Ligament ◽

Reference Group ◽

Cruciate Ligament ◽

Deep Infection ◽

Single Bundle ◽

Hamstring Autograft ◽

Kaiser Permanente ◽

Level Of Evidence ◽

Tibial Fixation ◽

Anterior Cruciate

Background: Hamstring autograft anterior cruciate ligament reconstructions (ACLRs) have exhibited higher infection rates compared with bone–patellar tendon–bone (BPTB) autograft. The reason for this observed difference is unclear, warranting investigation. Purpose: To evaluate the association between tibial fixation, either with or without a sheath and screw construct, and the risk of deep infection after hamstring autograft ACLR, using BPTB autograft as a reference group for comparison. Study Design: Cohort study; Level of evidence, 3. Methods: Using the Kaiser Permanente ACLR Registry, we identified all primary isolated, unilateral, single-bundle ACLRs with a BPTB or hamstring autograft (January 1, 2008, to September 30, 2016). The exposure groups included the following: (1) BPTB ACLR, (2) hamstring ACLR using a screw and sheath construct for tibial fixation (HS with screw and sheath), and (3) hamstring ACLR using a method other than a screw and sheath construct for tibial fixation (HS without screw and sheath). We used logistic regression to evaluate the likelihood of 90-day postoperative deep infection using BPTB autograft as the reference group and adjusting for age, sex, and body mass index. The number needed to be exposed (NNE) was calculated. Results: Of 15,671 ACLRs, 6745 (43.0%) used a BPTB graft, 2852 (18.2%) used HS with screw and sheath tibial fixation, and 6074 (38.8%) used HS without screw and sheath tibial fixation. There were 38 (0.2%) 90-day deep infections: 11 (0.2%) for BPTB, 14 (0.5%) for HS with screw and sheath, and 13 (0.2%) for HS without screw and sheath. Staphylococcus aureus for the BPTB group and Staphylococcus epidermidis in both hamstring groups were the most common infecting organisms. HS with screw and sheath had a higher likelihood of 90-day deep infection compared with BPTB ACLR (odds ratio [OR], 2.87; 95% CI, 1.29-6.38). We failed to observe a difference for HS without screw and sheath compared with BPTB ACLR (OR, 1.23; 95% CI, 0.54-2.77). The NNE was 330 and 2701 for HS with and HS without screw and sheath, respectively. Conclusion: Although the overall infection rate after ACLR is low, the higher likelihood of infections when sheath and screw combined are used for tibial fixation of a hamstring autograft ACLR should be a consideration when this procedure is performed.

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