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Quadruple hamstring anterior cruciate ligament reconstruction: a multicenter study
Pierce E Scranton1, James E Bagenstose, Brick A Lantz
1Orthopedics International, Seattle, Washington, USA. piercescranton@hotmail.com
Summary
This study shows quadruple hamstring anterior cruciate ligament (ACL) reconstruction using a low medial portal technique is successful. The technique, with a standardized rehabilitation protocol, improved patient outcomes and stability.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanical Engineering
Background:
- Arthroscopic anterior cruciate ligament (ACL) reconstruction commonly uses hamstring grafts.
- Blunt-threaded titanium interference screws are a fixation method for ACL grafts.
- The low medial portal technique for ACL reconstruction requires further evaluation.
Purpose of the Study:
- To prospectively evaluate the low medial portal technique for ACL reconstruction using quadruple hamstring grafts.
- To assess clinical outcomes and graft stability at 2-year follow-up.
- To establish a standardized rehabilitation protocol for this surgical approach.
Main Methods:
- A multicenter, prospective observational cohort study.
- 120 patients underwent quadruple hamstring ACL reconstruction with the low medial portal technique.
- Patients were evaluated at 2 years using Lysholm score, physical examination, and functional tests.
Main Results:
- Significant improvements were observed in Lysholm scores and functional test results.
- The overall failure rate was 4.17% (5 of 120), with causes including re-injury and technical error.
- Anterior knee pain (30%) and hamstring pain (22%) were reported but often did not impede athletic activity.
Conclusions:
- The low medial portal technique for quadruple hamstring ACL reconstruction demonstrates successful outcomes.
- Proper low medial portal placement is crucial for surgical success.
- Standardized rehabilitation and appropriate screw sizing are recommended for optimal results.