Fardin Mirzatolooei, Ali Tabrizi, Solmaz Gholizadeh,
Volume 7, Issue 4 (11-2020)
Abstract
Background: The anterior cruciate ligament surgery commonly uses a hamstring tendon. The hamstring grafts are usually prepared by wrapping in a wet gauze under tension.
Objectives: The placement of a hamstring tendon in a dry gauze affects the size of the graft, without any change in its collagen volume. The present study aimed to prove that the preparation method could affect the hamstring graft width.
Methods: A total number of 32 patients who had undergone the anterior cruciate ligament reconstruction were enrolled in this analytical descriptive study. Initially, the width of the 4-layered extracted graft was measured using the sizer system, after placement under traction. Then, 16 patients were operated on, based on the dry gauze preparation method, and the other 16, based on the wet gauze preparation method. The grafts were remeasured after traction. Six months after the surgery, all patients received a clinical evaluation, in which the integrity of the graft was evaluated based on clinical criteria.
Results: The Mean±SD width of the 4-layered extracted grafts was 7.44±0.54 mm and 7.41±0.33 mm in the dry gauze and wet gauze groups, respectively. However, these values did not significantly differ (P=0.96). After traction, the Mean±SD graft width of the dry gauze group was reduced to 6.97±0.62 mm. The traction led to no change in the graft width of the wet gauze group. The changes in the graft size significantly differed between the two groups (P=0.032). Moreover, 4 patients (25%) exhibited no certain endpoint in the Lachman test, also, the pivot shift-test was positive in 5 patients (31.2%).
Conclusion: The hamstring graft preparation technique affects the tunnel graft size. Besides, the use of dry gauzes procures the need for a narrower tunnel in the tibia and femur.
Mohsen Mardani-Kivi, Ehsan Kazemnejad Leili, Fatemeh Sharifi, Zoleikha Azari,
Volume 9, Issue 1 (2-2022)
Abstract
Background: Graft type selection is still a controversial issue in anterior cruciate ligament (ACL) reconstruction. The type of graft is a determinant of return to sport and its quality.
Objectives: This study aims to evaluate results and rate of return to sport using quadriceps autograft compared to hamstring autograft.
Methods: The present prospective cohort study investigated the results of using quadriceps and hamstring autografts in athletes with an ACL tear. Our variables included age, sex, and body mass index, type of sports activity, infection, meniscus tear and chondral lesion, time and quality of return to sport, range of motion, KT-1000, Lachman and knee injury and osteoarthritis outcome score, international knee documentation committee grade, and Lysholm score.
Results: A total of 71 out of 139 studied patients were operated on hamstring autografts and 68 patients by quadriceps autografts. The patients showed no significant differences (P>0.05) in terms of age, sex, body mass index, sports group, and meniscus tear. In the final follow-up, the chondral lesion was 26.47 vs 16.90, anterior knee pain was 5.8 vs 2.81, and the return to sport was 71.64 vs 78.87 in the quadriceps group vs the hamstring group. The extension loss involved 2 patients per group. The scores of the international knee documentation committee and knee injury and osteoarthritis outcome, the Lysholm test, KT-1000, and the Lachman test had no significant differences in the two groups.
Conclusion: The results of the present study indicated that the use of both quadriceps and hamstring autografts was appropriate for the ACL tear. Also, the orthopedic surgeon should be responsible for deciding to select one of the two grafts.
