Volume 8, Issue 2, April 2020, Page: 62-66
Preserved Tibial Attachment of Hamstring Graft Versus Detached Graft in Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Study
Patricio Espinoza Dumlao III, Sports Medicine and Arthroscopy Service, Department of Orthopedics, Philippine General Hospital, University of the Philippines, Ermita, Manila, Philippines
Lyndon Lovina Bathan, Sports Medicine and Arthroscopy Service, Department of Orthopedics, Philippine General Hospital, University of the Philippines, Ermita, Manila, Philippines
Patrick Mia Dizon, Sports Medicine and Arthroscopy Service, Department of Orthopedics, Philippine General Hospital, University of the Philippines, Ermita, Manila, Philippines
Received: Mar. 5, 2020;       Accepted: Mar. 20, 2020;       Published: Mar. 31, 2020
DOI: 10.11648/j.js.20200802.14      View  127      Downloads  54
Abstract
Background: Anterior cruciate ligament (ACL) reconstruction is one of the most frequent procedures done by orthopedic surgeons. Successful reconstruction is founded on fast healing and incorporation of tendon graft which translates to earlier and aggressive rehabilitation and faster return to dynamic activities. Recent studies highlighted the importance of biologic strategies in the enhancement of the recuperation process of autologous grafts for reconstruction. Current literature theorized the concept of maintaining the hamstring graft (HG) insertion but was unable to explicitly conclude an advantage of maintaining the attachment of the hamstring graft. Method: A prospective, double-blinded, randomized controlled study was done comparing graft integration through MRI (Figueroa) scoring system, and clinical outcomes through IKDC scores between the detached HG (control group) versus preserved tibial attachment of HG (test group) both augmented with interference screw fixation for ACL reconstruction. Results and Conclusion: A total of 32 patients were enrolled, 18 for the control group, 14 for the test group. Preoperative IKDC scores were similar for both groups. Post-operatively, a significant earlier peak at 3 months and continued improvement at 6 months is in favor of the test group. Consistently, there is also a 2.78-fold increased likelihood of graft healing and its constituent graft integration and ligamentization in the test group. This suggests that preservation of the neurovascular attachment of the HG is a contributory factor for efficient ligamentization and subsequent pain control, activities of daily living and functional capacity.
Keywords
Anterior Cruciate Ligament Reconstruction, Preserved Tibial Attachment, Hamstring Graft Ligamentization, Figueroa Scoring
To cite this article
Patricio Espinoza Dumlao III, Lyndon Lovina Bathan, Patrick Mia Dizon, Preserved Tibial Attachment of Hamstring Graft Versus Detached Graft in Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Study, Journal of Surgery. Vol. 8, No. 2, 2020, pp. 62-66. doi: 10.11648/j.js.20200802.14
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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