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General Orthopaedics

EFFECTS OF AUTOGENOUS HAMSTRING TENDON HARVESTING FOR ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION ON HAMSTRING STRENGTH AT DEEPER KNEE FLEXION ANGLES – DOES SINGLE VERSUS DOUBLE TENDON SACRIFICE AFFECT HAMSTRING STRENGTH?

Canadian Orthopaedic Association (COA)



Abstract

Purpose

The Purpose of this study was to evaluate hamstring strength after autogenous hamstring anterior cruciate ligament(ACL) reconstruction with emphasis on deeper knee flexion angles. A comparison of hamstring strength between patients undergoing ACL reconstruction using semitendinosus(ST), and those with semitendinosus and Gracilis(STG) tendons was conducted.

Method

Sixty patients were prospectively followed after undergoing ACL reconstruction surgery. Forty patients received a ST graft, and 20 patients had a STG graft. All patients had standard IKDC subjective knee evaluation completed, and had bilateral hamstring strengths tested using isokinetic testing with a Cybex Orthotron machine. In addition, a hand held Microfet dynamometer was used to measure hamstring strengths at deeper knee flexion angles at six, 12, and 24 months.

Results

When comparing the surgical hamstring strength compared to the control side at deeper knee flexion angle, the STG and ST group had and average of 65.0% and 79.8% strength respectively at 6 months(p<0.05). While at one year the STG and ST group had 63.6%, and 78.3% of their hamstring strength(p<0.05).

Conclusion

Hamstring strength at deeper flexion angles after ACL reconstruction using autogenous semitendinosus and gracilis tendons is significantly weaker than using semitendinosus alone. The use of single tendon ACL reconstruction should be advocated to decrease morbidity of this procedure.