Bilateral ACL Reconstructions with Hamstring Autografts

Abstract

Bilateral anterior cruciate ligament (ACL) injuries are rare with incidence between 2 and 4%, and presently no definitive guidelines for proper management exist. Ideal treatment protocol remains controversial between a single-stage and two-stage bilateral ACL reconstruction. The purpose of this study is to evaluate the outcome of single-stage bilateral ACL reconstruction with hamstring tendon autografts in bilateral ACL injuries. A prospective study was undertaken including a total of 14 consecutive patients with bilateral ACL deficient knee who underwent single-stage bilateral ACL reconstruction with hamstring tendon autograft with a mean follow-up duration of 28 months (24–38 months). Functional outcomes were evaluated by range of movements, International Knee Documentation Committee (IKDC), Lysholm and Tegner activity score, and stability tests. The mean age was 30 years (range 18–42 years). Average duration of rehabilitation was 8 weeks. Time to return to full-time work and full sports was 5.6 weeks and 6.2 months, respectively. Clinical examination demonstrated full range of motion; a total of 12 patients (86%) had a negative Lachman test and 13 patients (93%) had a negative pivot shift at the final follow-ups. The mean IKDC evaluation score was 89 points, the mean Tegner activity score was 7 points, and the mean Lysholm knee score was 91 points. A total of 12 patients (86%) returned to their preinjury level of activity and an overall greater than 90% satisfaction rate was achieved. Single-stage bilateral ACL reconstruction using hamstring autografts is clinically safe, effective, and cost-effective with better patient compliance and with comparable functional outcome as opposed to two-stage ACL reconstructions.

Keywords

arthroscopy - injuries - reconstruction - knee - rehabilitation

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