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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(04): e542-e548
DOI: 10.1055/s-0043-1770970
Artigo Original
Joelho

Bicruciate Reconstruction with Bilateral Hamstring Autografts: Technique and Functional Results

Article in several languages: português | English
Bruno Aspirino Ciancio 
1   Hospital Nipo Brasileiro, São Paulo, SP, Brasil
,
Marina Mayumi Azuma
1   Hospital Nipo Brasileiro, São Paulo, SP, Brasil
2   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
João Victor Medeiros De Cerqueira
2   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
,
Gustavo Kenzo Miyashita
1   Hospital Nipo Brasileiro, São Paulo, SP, Brasil
,
Jorge Liozi Yamashita
1   Hospital Nipo Brasileiro, São Paulo, SP, Brasil
,
Leonardo Addêo Ramos
1   Hospital Nipo Brasileiro, São Paulo, SP, Brasil
2   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
› Author Affiliations Financial Support The authors declare they have received no financial support from public, commercial, or non-profit sources.
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Abstract

Objective The purpose of this study was to evaluate the clinical and functional results of simultaneous reconstruction of the ACL and PCL with bilateral hamstring autografts. We hypothesized that this reconstruction technique results in less morbidity and has similar results to the ones published in the previous literature.

Methods Eighteen patients with bicruciate lesions were selected and treated by arthroscopic surgery with autologous hamstring tendons in a single-stage procedure. The thicker semitendinosus tendon (ST) and the two gracilis tendons (G) were used for a 6-strand PCL reconstruction. The thinner ST was used for a 3-strand ACL reconstruction. The average patient age at surgery was 31 years, and the minimum follow-up was 2 years. Function of the operated knee was evaluated according to the Lysholm scale. Anterior knee laxity was examined with a KT-1000 arthrometer. Posterior laxity was evaluated using stress radiographies.

Results Statistically significant improvements were found for all three measurements (p < 0.001). Knee function by the Lysholm score increased from 43.8 ± 4.1 to 89.9 ± 3.8 post-surgery. The average anterior knee laxity improved from 5.2 + -0.8 mm initially to 2.4 + - 0.5 mm post-surgery. The posterior translation of the tibia relative to the femur decreased from 10 ± 3.4 mm to 3 ± 1.6 mm post-surgery. No patient showed loss of motion in extension or knee flexion.

Conclusion The simultaneous bicruciate reconstruction with bilateral hamstring autograft is a valuable option to achieve good functional outcomes and ligamentous stability.

Keywords

anterior cruciate ligament - anterior cruciate ligament reconstruction - hamstring tendon - joint instability - knee dislocation - posterior cruciate ligament - posterior cruciate ligament reconstruction

Work carried out at the Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil.




Publication History

Received: 17 March 2022

Accepted: 24 January 2023

Article published online:
04 September 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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