Functional outcome of arthroscopic reconstruction of anterior cruciate ligament using tightrope with endobutton and interference screw

Abstract

Anterior Cruciate Ligament (ACL) injuries are one of the most commonly occurring ligament injuries in and around the knee joint. ACL gets torn easily and has a poor capacity for intrinsic repair. Anterior knee instability associated with ACL rupture is a disabling clinical entity. The current study has been designed to analyze the post-operative outcome of arthroscopically reconstructed ACL using a quadrupled autograft of semitendinosus and gracilis tendon which is fixed with an endo button on the femoral side and an interference screw on the tibial side. This was a prospective open label non-randomized interventional study. Subjects of both genders between 15 to 45 years presenting with an isolated ACL tear at M.N.R. Medical College & Hospital, Sangareddy, Telangana between June 2018 to May 2020 were included. Subjects were assessed for functional outcome and complications of arthroscopic ACL reconstruction. All the subjects were evaluated pre and post–operatively using clinical tests, the International knee documentation committee (IKDC) score, Lysholm Gilquist Score (LGS), and single leg hop test. A comparison between IKDC and LGS scoring was done to assess the functional outcome. An excellent outcome has been seen in 56.6%, a good outcome in 36.67% and 6.67% had a fair outcome using the LGS system. All three scoring systems showed a very high correlation as displayed by the Kendal-tau values ranging from 0.647 to 0.923. The pre-injury activity level was achieved in 97% of patients in a period of four to six months following strict rehabilitation protocol. The functional outcome of ACL reconstruction with quadrupled semitendinosus plus gracilis tendon autograft using a tightrope with endo-button and interference screw on femoral and tibial sides respectively is excellent to good (90%) with mild laxity noted objectively at the end of 6 months.