Arthroscopic Single-Bundle Anterior Cruciate Ligament Reconstruction With Periosteum-Enveloping Hamstring Tendon Graft: Clinical Outcome at 2 to 7 Years

Chih Hwa Chen, Chih Hsiang Chang, Chun I. Su, Kun Chung Wang, Hsien Tao Liu, Chung Ming Yu, Chak Bor Wong, I. Chun Wang

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Purpose: In this case-series outcome study, we present our surgical technique for single-bundle anterior cruciate ligament (ACL) reconstruction with periosteum-enveloping hamstring tendon graft at a minimum of 2 years' follow-up. Methods: From 2000 to 2005, ACL reconstruction with a periosteum-enveloping hamstring tendon graft was performed in 368 patients (372 knees). Of those patients, 312 who completed at least 2 years of follow-up were included for analysis. Four-strand periosteum-enveloping hamstring tendon grafts were used for single-bundle reconstruction. Clinical assessments included the Lysholm knee score, International Knee Documentation Committee score, KT-1000 instrumented testing (MEDmetric, San Diego, CA), thigh muscle assessment, and radiographic evaluation. Radiographs were used to assess femoral and tibial tunnel widening. Results: The 312 study patients were followed up for a mean of 4.6 years (range, 2 to 7 years). The median Lysholm knee scores were 56 points (range, 40 to 70 points) and 95 points (range, 60 to 100 points) before and after surgery, respectively. After reconstruction, 85% of patients could return to moderate or strenuous activity, 5.1% exhibited grade 2 or higher ligament laxity with the anterior drawer test, and 6.1% had a positive pivot shift. Complete range of motion was achieved in 88% of patients. On the basis of International Knee Documentation Committee assessment, 93% of patients had a normal or nearly normal rating. Conclusions: Satisfactory results can be achieved with the periosteum-enveloping hamstring tendon graft in single-bundle ACL reconstruction with minimal tunnel widening. Bone tunnel enlargement of more than 1 mm was identified in 5.4% of femoral tunnels and 6.1% of tibial tunnels, which was less than in other studies using comparable fixation. Level of Evidence: Level IV, therapeutic case series.

Original languageEnglish
Pages (from-to)907-917
Number of pages11
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume26
Issue number7
DOIs
Publication statusPublished - Jul 2010
Externally publishedYes

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Periosteum
Anterior Cruciate Ligament Reconstruction
Transplants
Thigh
Knee
Documentation
Articular Range of Motion
Ligaments
Hamstring Tendons
Outcome Assessment (Health Care)
Bone and Bones
Muscles

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Arthroscopic Single-Bundle Anterior Cruciate Ligament Reconstruction With Periosteum-Enveloping Hamstring Tendon Graft : Clinical Outcome at 2 to 7 Years. / Chen, Chih Hwa; Chang, Chih Hsiang; Su, Chun I.; Wang, Kun Chung; Liu, Hsien Tao; Yu, Chung Ming; Wong, Chak Bor; Wang, I. Chun.

In: Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol. 26, No. 7, 07.2010, p. 907-917.

Research output: Contribution to journalArticle

Chen, Chih Hwa ; Chang, Chih Hsiang ; Su, Chun I. ; Wang, Kun Chung ; Liu, Hsien Tao ; Yu, Chung Ming ; Wong, Chak Bor ; Wang, I. Chun. / Arthroscopic Single-Bundle Anterior Cruciate Ligament Reconstruction With Periosteum-Enveloping Hamstring Tendon Graft : Clinical Outcome at 2 to 7 Years. In: Arthroscopy - Journal of Arthroscopic and Related Surgery. 2010 ; Vol. 26, No. 7. pp. 907-917.
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abstract = "Purpose: In this case-series outcome study, we present our surgical technique for single-bundle anterior cruciate ligament (ACL) reconstruction with periosteum-enveloping hamstring tendon graft at a minimum of 2 years' follow-up. Methods: From 2000 to 2005, ACL reconstruction with a periosteum-enveloping hamstring tendon graft was performed in 368 patients (372 knees). Of those patients, 312 who completed at least 2 years of follow-up were included for analysis. Four-strand periosteum-enveloping hamstring tendon grafts were used for single-bundle reconstruction. Clinical assessments included the Lysholm knee score, International Knee Documentation Committee score, KT-1000 instrumented testing (MEDmetric, San Diego, CA), thigh muscle assessment, and radiographic evaluation. Radiographs were used to assess femoral and tibial tunnel widening. Results: The 312 study patients were followed up for a mean of 4.6 years (range, 2 to 7 years). The median Lysholm knee scores were 56 points (range, 40 to 70 points) and 95 points (range, 60 to 100 points) before and after surgery, respectively. After reconstruction, 85{\%} of patients could return to moderate or strenuous activity, 5.1{\%} exhibited grade 2 or higher ligament laxity with the anterior drawer test, and 6.1{\%} had a positive pivot shift. Complete range of motion was achieved in 88{\%} of patients. On the basis of International Knee Documentation Committee assessment, 93{\%} of patients had a normal or nearly normal rating. Conclusions: Satisfactory results can be achieved with the periosteum-enveloping hamstring tendon graft in single-bundle ACL reconstruction with minimal tunnel widening. Bone tunnel enlargement of more than 1 mm was identified in 5.4{\%} of femoral tunnels and 6.1{\%} of tibial tunnels, which was less than in other studies using comparable fixation. Level of Evidence: Level IV, therapeutic case series.",
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AU - Su, Chun I.

AU - Wang, Kun Chung

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