ABSTRACT
Objective To arthroscopically re-observe the remodeling and maturity process following anterior cruciate ligament(ACL) reconstruction with a hamstring tendon autograft.Methods Thirty-three patients who had undergone a previous arthroscopic ACL reconstruction with a homolateral hamstring autograft were given a second observation under arthroscope.The interval from initial reconstruction to second-look arthroscopy ranged 2~36 months(mean,11.9 months).According to different intervals,the patients were grouped as 1~,4~,7~,10~,13~,18~,and 25~ months.The shape,color,tension,covering synovial tissue,and vascularity of the grafts were evaluated.Results As the interval increased,the hamstring grafts tended to progress to normal ACL morphologically.Under arthroscopic observation,the tendon grafts were characterized as grayish-white thick ligamentous tissues without synovial membrane and blood vessels after 7 months following initial reconstruction,which corresponded with the maturation period of autogenous grafts and simulated normal ACL.Conclusions Remodeling and maturation of the hamstring autografts progresses with time,which is comparable to patellar tendon autografts.
ABSTRACT
PURPOSE: To evaluate the healing status of reconstructed anterior cruciate ligament (ACL) and meniscal repair through second-look arthroscopy after arthroscopic reconstruction of the ACL. MATERIALS AND METHODS: We analyzed 81 cases by second-look arthroscopy among 397 cases that received ACL reconstruction during the period from June 1996 to December 2000. Second-look arthroscopy was conducted on average 18.8 months after reconstruction. 53 cases received a patellar tendon autograft, 28 cases received a hamstring tendon autograft and 29 cases received meniscal repair. We measured graft tension using displacement by probing, and synovial coverage by visual analysis at second-look arthroscopy. The improvements in Lysholm knee scores and KT-2000 arthrometer results were evaluated to compare patellar and hamstring tendons. RESULTS: The patellar tendon group showed normal tension in 41 cases and lax tension in 12 cases. The hamstring tendon group showed normal tension in 22 cases and lax tension in 6 cases. In the patellar tendon group, synovial coverage was good in 38 cases, half in 4 cases, and pale in 11 cases, whereas the hamstring tendon group was good in 25 cases, half in 2 cases, and pale in 1 case. Synovial coverage was better in the hamstring tendon group (p<0.05). Although there was no statistical significance, the hamstring tendon group was superior to the patellar tendon group in terms of graft tension, Lysholm knee scores and KT-2000 arthrometer results. CONCLUSION: The hamstring tendon group with ACL reconstruction was superior to the patellar tendon group, but long term follow-up will be necessary to further evaluate results.