Abstract
The purpose of this study was to describe our surgical technique of using five-strand
hamstring autograft with interference screw fixation in primary anterior cruciate
ligament (ACL) reconstruction and to report the early postoperative outcomes of this
technique. Patients who underwent primary ACL reconstruction using five-strand hamstring
autografts with interference screw fixation between December 2014 and June 2016 were
included in this study. The five-strand configuration was used in these patients because
the four-strand configuration produced a graft diameter of less than 8 mm. Subjective
questionnaires, including the Knee Injury and Osteoarthritis Outcome Score (KOOS)
and the Lysholm Score, were administered preoperatively, as well as at 1- and 2-year
follow-ups. Paired t-test was used to compare the pre- and postoperative outcome scores. The study group
comprised 25 patients. There were no intraoperative complications. The mean follow-up
period was 17.8 months (12–24). There were 19 males and 6 females. The median age
was 24 years (16–41), and median body mass index was 23.9 (18.5–30.2). The median
diameter of the five-strand graft was 9 mm (8–10 mm), with a mean of 9.06 ± 0.60 mm.
This was associated with a median graft length of 90 mm (80–100 mm). The postoperative
Lysholm, KOOS symptoms, KOOS Pain, KOOS daily function, KOOS sports function, KOOS
quality of life, and Short Form-36 Physical Component Summary scores improved significantly
compared with the preoperative scores. The use of the five-strand hamstring graft
with interference screw fixation in primary ACL reconstruction is associated with
significant improvements in patient-reported outcomes in the early postoperative period.
The five-strand graft technique is a useful means of increasing graft diameter when
faced with an undersized hamstring graft.
Keywords
five-strand hamstring autograft - ACL reconstruction - interference screw - clinical
outcomes
