Pain assessment after anterior cruciate ligament reconstruction with autograft: quadrupled m.semitendinosus versus m.semitendinosusand m.gracilis

Abstract

Anteriorcruciate ligament (ACL) tear is one of the most common sports injuries. The all-inside technique (AIT) for anterior cruciate ligament reconstruction (ACLR) is gaining popularity as a more anatomic, less invasive technique with the potential for more rapid recovery. With the recent advances in the field of sports medicine, the all-inside technique is reported to have less postoperative pain as compared to the conventional transportable procedure. The purpose of this research is to determine the differences in acute pain levels between undergoing ACL reconstruction hamstring autograft m. semitendinosusand m.gracilis versus hamstring autograft quadrupled m.semitendinosus in first and second postoperative day. Materials and Methods: A total of 80 patients in period of two years who underwent primary ACL reconstruction using either HS autograft m.semitendinosusand m.gracilis or HS autograft quadrupled m.semitendinosus consented to participate. The primary outcome of the study was postoperative pain levels that were collected after surgery at first and second day. For the quantification of the intensity of pain after the surgery the patients were offered a Visual Analogue Scale (VAS scale), numbered from 0 to 10 (0 means no pain, 10 is the strongest pain). This part of the research shows the results obtained by processing patients with ACL, treated at the Department of Orthopaedics and Traumatology in the City General Hospital "8th of September" in Skopje. Results: The average postoperative score one day after surgery for patients with a standard method using a graft in the form of a duplication of m.semitendinosus and m.gracilis based on the VAS  scale was 7.70 +0.9 and the score second day after surgery was 4.75 + 1.1.The average postoperative score a day after the surgery for patients treated with the method where only m.semitendinosus is used as a graft and that in the form of quadruplicationbased on the VAS  scale was 3.90 +3.1and the score second day after surgery was 2.70 +2.7. Conclusion: A significant reduction in acute postoperative pain was found when performing ACL reconstruction with HS quadrupledm.semitendinosus compared to HS m.semitendinosus-m.gracilis.