Volume 71, Issue 8 (November 2013)
Tehran Univ Med J 2013, 71(8): 509-517 |
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Moghtadaei M, Nabi R, Amiri A, Mokarami F. Outcome of hamstring ligament harvest for Anterior Cruciate Ligament reconstruction with allograft versus autograft: a clinical trial. Tehran Univ Med J 2013; 71 (8) :509-517
URL: http://tumj.tums.ac.ir/article-1-5607-en.html
URL: http://tumj.tums.ac.ir/article-1-5607-en.html
1- Department of Orthopedic Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Orthopedic Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. ,md_natan@yahoo.com
3- Department of Physicaltherapy Iran University of Medical Sciences, Tehran, Iran.
2- Department of Orthopedic Surgery, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. ,
3- Department of Physicaltherapy Iran University of Medical Sciences, Tehran, Iran.
Abstract: (7924 Views)
Background: The goal of this study was to evaluate, functional capacity of the knee in flexion and internal rotation after hamstring ligament harvest for Anterior Cruciate Ligament (ACL) reconstruction.
Methods: Fifty patients (male and 18-45 years old) with isolated ACL injury, randomly allocated in two equal groups (in one group, ACL reconstruction was performed with Tibialis Posterior allograft and in another group with quadruple hamstring ligament auto graft) and before and 6 months after surgery in both groups isokinetic flexion strength and isometric internal rotation strength of knee evaluated with Biodex System 4 dynamometer and rotational torque recorder, in order. Isokinetic flexion strength evaluated in sitting and prone position the later position was performed for deep flexion strength evaluation. Also subjective and objective assessment of all patients pre operatively and 6 months post operatively was documented with International Knee Documentation Committee (IKDC) questionnaire. In this study for first time, rotational torque strength of knee was recorded with new design measure, from isometric aspect and not isokinetic.
Results: Although significant improvements in IKDC scores, flexion and internal rotation capacity of the knee were observed in both groups, post operatively in respect to pre operatively there was no significant difference between 2 groups. (P<0.05 or more than 95% confidence Interval of the difference)
Conclusion: This study demonstrates that ACL reconstruction surgery, improves knee performance in flexion and internal rotation, regardless of hamstring tendon harvesting. Considering potential complications of allograft (for example: transfer of harmful diseases from donor to recipient), it is logical to use hamstring auto graft ligament for ACL reconstruction surgery. Because result of this study is not longstanding follow up and limited to male sex, for more worthfull conclusion, we suggest future study in both sex and with long duration of follow up.
Methods: Fifty patients (male and 18-45 years old) with isolated ACL injury, randomly allocated in two equal groups (in one group, ACL reconstruction was performed with Tibialis Posterior allograft and in another group with quadruple hamstring ligament auto graft) and before and 6 months after surgery in both groups isokinetic flexion strength and isometric internal rotation strength of knee evaluated with Biodex System 4 dynamometer and rotational torque recorder, in order. Isokinetic flexion strength evaluated in sitting and prone position the later position was performed for deep flexion strength evaluation. Also subjective and objective assessment of all patients pre operatively and 6 months post operatively was documented with International Knee Documentation Committee (IKDC) questionnaire. In this study for first time, rotational torque strength of knee was recorded with new design measure, from isometric aspect and not isokinetic.
Results: Although significant improvements in IKDC scores, flexion and internal rotation capacity of the knee were observed in both groups, post operatively in respect to pre operatively there was no significant difference between 2 groups. (P<0.05 or more than 95% confidence Interval of the difference)
Conclusion: This study demonstrates that ACL reconstruction surgery, improves knee performance in flexion and internal rotation, regardless of hamstring tendon harvesting. Considering potential complications of allograft (for example: transfer of harmful diseases from donor to recipient), it is logical to use hamstring auto graft ligament for ACL reconstruction surgery. Because result of this study is not longstanding follow up and limited to male sex, for more worthfull conclusion, we suggest future study in both sex and with long duration of follow up.
Keywords: Anterior cruciate ligament reconstruction, autologous transplant, autologous transplantation, biomechanics, knee
Type of Study: Original Article |
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