Abstract: Objectives: This study aimed to compare the clinical and MRI results of anterior cruciate ligament (ACL) reconstruction with tibial attachment preserving hamstring grafts (HG) against the conventional ACL reconstruction using the detached HG.
Methods: This retrospective comparative study was conducted on patients who underwent arthroscopic single bundle anatomical ACL reconstruction. The functional assessment and return to sports activities was evaluated by pre- and postoperative Lysholm score and Tegner activity score in group I (detached Hamstrings autograft) and in group II (reconstruction was performed using attachment sparing hamstring graft). The radiological evaluation was performed by the MRI (1.5-tesla whole-body scanner) performed at 1-year post-reconstruction. P-Value < 0.05 was considered as significant.
Results: In Groups I and II, Lachman test postoperatively improved to grade 0 in 76% and 90% patients, respectively (p<0.0001). The mean improvement in the Lysholm score was significantly higher in Group II as compared to Group I (32.467 vs. 28.440, p<.0001). In Group I, the mean Tegner activity score improved from 2±0.71 (pre-operatively) to 3.52±0.65 (post-operatively), p<0.0001 and in Group II, it improved from 2±0.64 (pre-operatively) to 5.2±1.03 (post-operatively), p<0.0001. Graft ligamentization was better in Group II as compared to Group I (p<0.0001) with 70% cases having Figueroa score 5 as compared to 24% in Group I.
Conclusion: In conclusion, preservation of HG tibial insertion provides a better functional recovery, graft ligamentization and graft integration in cases with ACL reconstruction.
