Jae-Ang Sim; Sang-Hoon Yang; Byoung-Keun Ahn; Beom-Koo Lee

doi:10.4055/jkoa.2009.44.3.311

Journal List > J Korean Orthop Assoc > v.44(3) > 1012907

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Sim, Yang, Ahn, and Lee: Short-term Follow-up of Double Bundle ACL Reconstruction using Autogenous Hamstring Tendons Fixed with Ligament Plate®

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(3): 311-319.

Published online: 18 June 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.3.311

Short-term Follow-up of Double Bundle ACL Reconstruction using Autogenous Hamstring Tendons Fixed with Ligament Plate®

Jae-Ang Sim, M.D., Sang-Hoon Yang, M.D.^*, Byoung-Keun Ahn, M.D., Beom-Koo Lee, M.D.

Department of Orthopaedic Surgery, Gil Medical Center, Gachon University, Incheon, Korea.

^*Sungmin General Hospital, Incheon, Korea.

Address reprint requests to Beom-Koo Lee, M.D. Department of Orthopaedic Surgery, Gil Medical Center, Gachon University, 1198, Kuwol-dong, Namdong-gu, Incheon 405-760, Korea. Tel: +82.32-460-3384, Fax: +82.32-468-5437, bklee@gilhospital.com

Abstract

Purpose

We wanted to evaluate the clinical outcomes at a minimum 1-year following anatomic double bundle ACL reconstruction with using autogenous hamstring tendons fixed with Ligament Plate®.

Materials and Methods

We evaluated a total of 50 patients. Semitendinosus tendon was used for the reconstruction of the anteromedial bundle and the gracilis tendon was used for the reconstruction of the posterolateral bundle. For femoral fixation, we used an anteromedial bundle that was suspended in Ligament Plate® and a posterolateral bundle linked with Mersilene tape®. For tibial fixation, we used double post-tie. The average follow-up period was 16.5 months. We analyzed the clinical and radiographic results.

Results

At the last follow-up, the Lysholm score was 92.4±6.8 points. For the IKDC score, there were 35 cases of grade A, 14 cases of grade B and 1 case of grade C. The Lachman test was negative for 40 cases, it was grade 1 for 9 cases and it was grade 2 for 1 case and the pivot shift test was negative for 45 cases and it was grade 1 for 5 cases. The side-to-side differences with the KT-2000 and the anterior drawer radiogram were 1.3±1.6 mm and 1.3±1.3 mm, respectively. The femoral tunnel enlarged to 1.7±0.6 mm in the anteromedial aspect and 1.6±0.7 mm in the posterolateral aspect, and the tibial tunnel enlarged to 1.2±0.4 mm in the anteromedial aspect and 1.4±0.5 mm in the posterolateral aspect.

Conclusion

Anatomic ACL reconstruction using autogenous hamstring tendons that are fixed with Ligament Plate® showed good clinical results due to the strong strength of early fixation and the anatomic restoration of the ACL.

Keywords: Double bundle ACL reconstruction, Hamstring tendon, Ligament plate®

Figures and Tables

Fig. 1

Three or four strands semitendinosus tendon is used for the anteromedial bundle and four strands gracilis tendon with Mersilene tape® is used for the posterolateral bundle (arrow: tension tie, arrow head: terminal tie).

Fig. 2

Illustrations show the placement of the femoral (A) and the tibial (B) tunnels.

Fig. 3

We check out the position of guide pins by image intensifier.

Fig. 4

We perform the fixation of graft in 15° knee flexion. In femoral fixation, we make the anteromedial bundle directly and posterolateral bundle with Mersilene tape® hang on Ligament Plate® (A). In tibial fixation, we make double post-tie by tension and terminal tie (B, arrow: tension tie, arrow head: terminal tie).

Fig. 5

Arthroscopic findings show double bundle ACL reconstruction immediately postoperatively (A) and well synovial coveraged and vascularized grafts without laceration or elongation at postoperative 8 months (B).

Fig. 6

Radiographs show anatomic double bundle ACL reconstruction using hamstring tendon fixed with Ligament Plate®.

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