Abstract
Background
Anterior Cruciate Ligament Reconstruction is a commonly performed orthopaedic operation. The use of a four-strand semitendinosus and gracilis hamstring graft (STG) is a well established method of reconstruction to restore knee stability.
Aim
To assess the ten year subjective knee function and activity level following STG anterior cruciate ligament reconstruction.
Methods
86 patients underwent anterior cruciate reconstruction by two knee surgeons in the year 1999. 80 patients meet the inclusion criteria of STG reconstruction by a standard operative technique. Patient evaluation was by completion of a Lysholm Knee Score and Tegner Activity Level Scale at a minimum of ten years from reconstructive surgery. This was by initial postal questionnaire and subsequent telephone follow-up.
Results
80 patients underwent anterior cruciate reconstruction with average age 30.9 years +/− 8.8 (15 to 58 years). There was a 77.5% (62 patients) response at ten years to the questionnaire.
The mean Lysholm Knee Score at ten years was 78.4 +/− 12.8 (39 to 90). The mean activity level had decreased from 8.3 to 5.3 at ten years according to the Tegner Activity Scale.
11 patients required medial and lateral partial menisectomies at the time of original reconstruction. This group of patients had a Lysholm Knee Score of 67.6 +/− 19.1 and Tegner Activity Scale of 3.9 at ten years following reconstruction.
17 of the 80 patients (21.25%) required re-operation because of further knee symptoms, with 4 patients requiring revision of the anterior cruciate following re-rupture.
Conclusion
Anterior Cruciate Ligament Reconstruction with four-strand STG hamstring graft provides a reliable method of restoring knee function with a 5% revision rate for re-rupture at ten years. Combined partial medial and lateral menisectomy at the time of the initial reconstruction is a poor prognostic indicator for function at ten years.
