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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanical Engineering

Background:

  • Anterior cruciate ligament reconstruction (ACLR) is a common procedure aiming for return to preinjury sporting levels.
  • Optimized techniques focus on reduced morbidity and accelerated recovery for athletes.
  • Comparing different ACLR graft harvesting methods is crucial for clinical decision-making.

Purpose of the Study:

  • To compare clinical and imaging outcomes of two ACLR techniques: hamstring maintaining tibial insertion (MHG) and all-inside with complete hamstring detachment (DHG).
  • To evaluate the timing of return to sport after ACLR using these distinct hamstring graft harvesting methods.
  • To assess long-term functional recovery and patient-reported outcomes at a minimum of 4 years follow-up.

Main Methods:

  • A comparative study of 59 patients undergoing unilateral ACLR (31 MHG, 28 DHG) with homogeneous characteristics.
  • Clinical evaluation using Marx rating scale, International Knee Documentation Committee (IKDC) score, and Tegner activity scale.
  • Follow-up assessments conducted at 12 months and final follow-up (minimum 4 years).

Main Results:

  • Both MHG and DHG techniques showed significant improvement in clinical scores and a high return to preinjury sporting level (98%).
  • The MHG group reported a higher percentage of normal knees (83.8% vs. 78.6%) and superior IKDC scores at 12 months (89.6 vs. 84.2).
  • Return to sport timing was slightly longer for MHG (6.3 months) vs. DHG (5.9 months), but long-term activity levels were comparable.

Conclusions:

  • Both hamstring graft techniques for ACLR are effective in achieving good clinical results and high rates of return to professional sport.
  • The MHG technique may offer slightly better short-term functional outcomes and knee status.
  • Long-term sporting activity levels are comparable between the techniques, highlighting the overall success of both surgical approaches.