Document Type : RESEARCH PAPER
Department of Orthopaedics, Vardhman Mahavir Medical College, New Delhi
Department of Orthopedics, Lady Hardinge Medical College, New Delhi
Department of Orthopedics, All India Institute of Medical Sciences, Raipur
Background: Arthroscopic ACL reconstruction using hamstring autograft is a quite a popular surgical procedure.
But there is a conflict regarding the use of isolated semitendinosus graft or a combined hamstring graft. We did a
comparative analysis of the functional outcome after ACL reconstruction performed with four strand semitendinosus
graft and a combined hamstring graft over tightrope.
Methods: Two groups of 30 patients each with similar demographic profiles, presenting with symptoms of instability
after chronic ACL tear were included. A standard single bundle arthroscopic ACL reconstruction was performed by using
four-strand semitendinosus graft in Group A and combined hamstring graft in Group B patients. Clinical and functional
outcome analysis was done using quantitative anterior tibial translation measurement and Lysholm score.
Results: The mean age of subjects in group A was 29 years and in Group B was 28 years. The semitendinosus
graft length was insufficient in 13.33% cases in group A. The improvement in Lysholm score and the decrease in the
tibial translation were comparable in both the groups at one year of follow-up. No added comorbidities were noted in
additional removal of gracilis tendon in group B patients.
Conclusion: Isolated semitendinosus four-strand autograft can be used for arthroscopic single bundle ACL
reconstruction when adequate graft length is obtained. However, one should not be hesitant in additional removal of
gracilis tendon when needed. In terms of functional outcome and patient satisfaction, both the graft configurations stand
Level of evidence: I