Outcome of different autogenous ACL reconstruction in University Malaya Medical Centre

Although not life-threatening, rupture of the anterior cruciate ligament (ACL) can severely impair activities of daily living and quality of life. ACL reconstruction is an accepted modality of treatment but failure rates as high as 25 have beeb reported. In view of this, we reviewed the clinicaloutc...

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Bibliographic Details
Main Authors: Azura, M., Razif, A., Chan, K.Y., Mukundala, V.V., Kwan, M.K., Ramami, T.
Format: Article
Language:English
Published: 2005
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Online Access:http://eprints.um.edu.my/3334/1/Outcome_of_Different_Autogenous_ACL_Reconstruction_in_University_Malaya_Medical_Centre.pdf
http://eprints.um.edu.my/3334/
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Summary:Although not life-threatening, rupture of the anterior cruciate ligament (ACL) can severely impair activities of daily living and quality of life. ACL reconstruction is an accepted modality of treatment but failure rates as high as 25 have beeb reported. In view of this, we reviewed the clinicaloutcome of 33 patients who had undergone arthroscopic-assisted autogenous graft reconstruction using either patella-tendon or hamstring graft following anterior cruciate ligament (ACL) rupture in UMMC between 2000 to 2003. This study was also conducted to compare the outcome of the two different types of autogenous graft used for ACL reconstruction which are the bone-patella tendon-bone (BPB) and hamstring (HS) grafts. Patients between the ages of 17 to 48 years (mean age of 27.8 years) were evaluated at 1 to 3 years post-operatively using various clinical parameters which include functional index, subjective and objecyive scores and an objective measurement using KT 1000 arthrometer. On the overall, patients operated in our centre did well with 6 (n=2) failures reported. Both the BPB and HS groups had good to excellent results post operatively. Ninety seven percent (n=32) of the patients were able to kneel and squat with more than half of them achieving >90 single-legged hop test. Eighty eight percent of patients (n=29) achieved normal to nearly normal subjective IKDC score. The mean Lysholm score was 92.2, with 97 (n=32) scored excellent (80 points or more). More than 90 had equal or less than 2 Tegner activity-level drop. The mean KT 1000 side by side differences was 1.71mm, with 94 had less than 4mm difference. Even though the BPB group was observed to have a higher mean Lysholm score (92.6) compared to the HS group (91.8), they were statistically significant. The BPB group had a significantly less residual laxity with the KT 1000 side to side different of 1.1mm compared with the HS group of 1.9mm. However no correlation between laxity and any of the outcome scores were noted. In conclusion, ACL reconstruction procedures performed in UMMC have yield good to excellent short term results.