Early results of reconstruction of chronic anterior cruciate ligament ruptures using four-strand hamstring tendon autografts

Objectives: We evaluated the short-term results of recon¬struction of anterior cruciate ligament (ACL) ruptures using a four-strand hamstring autograft and cross pin femoral fix¬ation. Methods: The study included 62 male patients (mean age 24 years; range 21 to 44 years) with chronic ACL ruptures. Involvement was in the right knee in 32 patients, and in the left knee in 30 patients. All the patients were treated with a four-strand hamstring autograft, cross pin femoral fixation (Transfix, Arthrex and Sling Shot, Mitek), and an interfer¬ence screw on the tibial side. Forty-one patients received treatment for other meniscal pathologies. Final evaluations were made at the end of postoperative 18 months using the Lysholm and IKDC (International Knee Documentation Committee) scoring systems, Telos stress testing, Tegner activity rating, and radiographs. Results: The Lysholm scores were good (n=23) or excel¬lent (n=38) in 61 patients, and poor in one patient, the mean Lysholm score being 93.5. The IKDC scores were grade A (n=35) or B (n=26) in 61 patients, and grade D in one patient. Telos stress testing showed a significant difference between preoperative (mean 14.5 mm) and postoperative (mean 2.6 mm) laxity measurements (p<0.001). None of the patients had a graft rupture. One patient who developed grade III instability after postoperative six months under¬went second-look arthroscopy followed by revision surgery. Conclusion: Reconstruction of the ACL using four-strand hamstring tendons and cross pin femoral fixation results in considerably high success rates in selected patients.