Lim CR, Henson T, Ebert J, Annear P. Anterior cruciate ligament reconstruction using a double bundle hamstring autograft configuration in patients under 30 years. World J Orthop 2019; 10(12): 446-453 [PMID: 31908993 DOI: 10.5312/wjo.v10.i12.446]
Corresponding Author of This Article
Christopher Reece Lim, BSc, MBBS, Doctor, Medical Doctor, Department of Orthopaedics, Sir Charles Gairdner Hospital, Hospital Ave, Western Australia, Nedlands 6009, Australia. christopherlim22@gmail.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Control Study
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Lim CR, Henson T, Ebert J, Annear P. Anterior cruciate ligament reconstruction using a double bundle hamstring autograft configuration in patients under 30 years. World J Orthop 2019; 10(12): 446-453 [PMID: 31908993 DOI: 10.5312/wjo.v10.i12.446]
World J Orthop. Dec 18, 2019; 10(12): 446-453 Published online Dec 18, 2019. doi: 10.5312/wjo.v10.i12.446
Anterior cruciate ligament reconstruction using a double bundle hamstring autograft configuration in patients under 30 years
Christopher Reece Lim, Tamalee Henson, Jay Ebert, Peter Annear
Christopher Reece Lim, Department of Orthopaedics, Sir Charles Gairdner Hospital, Western Australia, Nedlands 6009, Australia
Tamalee Henson, Fiona Stanley Hospital, Western Australia, Murdoch 6150, Australia
Jay Ebert, School of Human Sciences (Exercise and Sport Science), University of Western Australia, Western Australia, Crawley 6009, Australia
Peter Annear, Perth Orthopaedic and Sports Medicine Centre, Western Australia, West Perth 6005, Australia
Author contributions: Lim CR is primary author, responsible for data collection and interpretation of results, writing of the manuscript and editing of the manuscript. Ebert J was responsible for interpretation of results and editing of the manuscript. Henson T contributed to data collection. Annear P was responsible for development of the original idea, interpretation of the results and editing of the manuscript.
Institutional review board statement: Attached is a copy of the ethics approval granted for the purpose of this study in 2015 which was originally written in the English language.
Informed consent statement: Attached is a copy of the patient consent forms used for the study which was originally written in the English language.
Conflict-of-interest statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Data sharing statement: Technical appendix, statistical code, and datasets are available from the corresponding author at christopherlim22@gmail.com. Consent was not obtained but the presented data are anonymized and risk of identification is low.
STROBE statement: The guidelines of the STROBE Statement have been adopted.
Corresponding author: Christopher Reece Lim, BSc, MBBS, Doctor, Medical Doctor, Department of Orthopaedics, Sir Charles Gairdner Hospital, Hospital Ave, Western Australia, Nedlands 6009, Australia. christopherlim22@gmail.com
Telephone: +61-43-2835277
Received: January 14, 2019 Peer-review started: January 14, 2019 First decision: March 15, 2019 Revised: April 4, 2019 Accepted: September 22, 2019 Article in press: September 22, 2019 Published online: December 18, 2019 Processing time: 331 Days and 17.9 Hours
Abstract
BACKGROUND
Anterior cruciate ligament reconstruction (ACLR) has a high incidence of re-tear in younger patients. Despite comparable functional outcomes, the incidence of re-tear using single and double bundle ACLR methods has not been well reported.
AIM
To hypothesize that double bundle hamstring ACLR has a lower graft rupture rate compared with single bundle hamstring ACLR grafts in young patients.
METHODS
One hundred and twelve patients < 30 years of age at the time of primary double bundle ACLR were eligible for study participation. 91 (81.3%) could be contacted, with a mean age of 20.4 years (range 13-29) and mean post-operative follow-up time of 59 mo (range 25-107). Telephone questionnaires evaluated the incidence (and timing) of subsequent re-tear and contralateral ACL tear, further surgeries, incidence and time to return to sport, and patient satisfaction.
RESULTS
Of the 91 patients, there were 6 (6.6%, 95%CI: 1.4-11.7) ACL graft re-ruptures, with a mean time to re-rupture of 28 mo (range 12-84). Fourteen patients (15.4%) experienced a contralateral ACL rupture and 14 patients (15.4%) required further surgery to their ipsilateral knee. fifty patients (54.9%) returned to pre-injury level of sport. Of those < 20 years (n = 45), 4 patients (8.9%, 95%CI: 0.4-17.3) experienced a re-rupture, with mean time to re-injury 15 mo (range 12-24). Comparative analysis with existing literature and revealed a non-significant Chi-squared statistic of 2.348 (P = 0.125).
CONCLUSION
A trend existed toward lower graft rupture rates in young patients undergoing double bundle ACLR utilizing a hamstring autograft, compared with rates reported after single bundle ACLR.
Core tip: Double bundle anterior cruciate ligament (ACL) reconstruction has a low re-rupture rate (6.6%) in the young, active population. In addition, re-rupture rates are shown to be at least comparable with Single Bundle ACL reconstructions techniques.
