Short-term functional outcome of Anterior cruciate Ligament Reconstruction with tibial attachment preserving Hamstring graft with femoral side fixation only

Background: Free Hamstring, Bone patellar tendon-bone, Peroneus Longus, and quadriceps tendon grafts are widely being used for Anterior cruciate ligament (ACL) reconstruction with a satisfactory outcome. Free grafts are avascular and theirs tibial side fixation insufficiency is a potential cause of failure in ACL reconstruction. Tibial attachment preserving hamstring graft preserves the vascularity and mechanical strength on the tibial side, and could be a viable option in an anterior cruciate ligament (ACL) reconstruction, The authors describe the early outcome of the surgical technique of ACL reconstruction (ACLR) with tibial attachment sparing hamstring graft without implant on the tibial side. Material and methods: The hamstring insertion preserving five stranded graft was used for ACL reconstruction with adjustable endobutton for femoral side fixation and no implant for tibial side fixation. Thirty-six patients with one-year follow-ups were included in the study. Results: The mean length of the prepared graft attached to the tibia was 95.5 ± 4 mm, and the mean width was 8.6 ± 0.7 mm and 8.2 ± 0.6 mm on the tibial and femoral side respectively. None had a failure of graft till the final follow-up. The preoperative International knee documentation committee score (IKDC) mean score improved from 47.3 ± 8.9 to 87.3 ± 6.7 at one-year follow-up. The preoperative Lysholm score (LS) improved from 58.1 ± 12.8 to 90.4 ± 4.9 at one-year follow-up. Conclusion: Attachment-sparing hamstring graft with a femoral side-only implant is a simple, cost-effective technique that provides a satisfactory outcome.