Anterior cruciate ligament reconstruction using four-strand semitendinosus and gracilis tendon grafts and metal interference screw fixation

Purpose: The purpose of this study was to determine the outcome of 200 anterior cruciate ligament (ACL) reconstructions using hamstring tendons. Type of Study: This is a case series reporting on 200 endoscopic procedures for reconstruction of the ACL. Methods: This study included patients over 18 years old with a healthy controlateral knee, intact posterior cruciate ligament, and without any peripheral surgical procedure or cartilage injury. Patients having undergone prior ligament reconstruction were excluded from the study. The minimum follow-up was 1 year. Clinical review allowed for documentation of International Knee Documentation Committee (IKDC), KT-1000 arthrometer laxity measurement, and isokinetic dynamometric analysis. Results: Quadriceps and hamstring muscle strength loss was less than 17%. At review, overall IKDC evaluation found that 50% of patients graded A, 44% graded B, and 6% were C or D. The differential anterior laxity was graded A for 157 patients with a median of I mm. Of the 113 high-performance athletes, 98 (86%) had resumed a preinjury level of sporting activity. Conclusions: Endoscopic reconstruction using 4-strand hamstring autograft may be considered safe, reliable, and reproducible. Preliminary outcome is fulfilling and this technique corresponds completely to therapeutic fields regarding ACL reconstructions.