Clinical and Radiological Outcome Assessment Study between Aperture and Suspensory Fixation of Hamstring Autografts on Femoral Side in ACL Reconstruction

Abstract

Background: Arthroscopically aided anterior cruciate ligament reconstruction using hamstring graft can be fixed to femoral condyle by suspensory and aperture fixation methods.

Objectives: To investigate functional outcomes with these fixation methods as measured by the Lysholm knee score of Hamstring autografts.

Methods: 50 patients of clinically and radiologically diagnosed ACL tear fulfilling the inclusion and exclusion criteria were randomized into two groups to undergo arthroscopic ACL reconstruction using quadrupled hamstring graft with suspensory (n=25) and aperture (n=25) fixation methods on femoral side. They were compared post operatively with Lysholm score, clinical laxity tests and percentage of tunnel enlargement using computed tomograms at 01 year.

Results: At the end of 6 months there was no much difference in Lysholm score between both the groups (P =0.63) and at the end of 01 year aperture group had slightly better outcome. However, the difference was not statistically significant (p =0.13). There were more tunnels widening in the suspensory group especially of the femoral tunnel in the coronal plane. However, the amount of tunnel widening in both the groups was not significant statistically (P =0.071 and P =0.963).

Conclusions: Aperture and Suspensory fixation methods of hamstring graft at femoral condyle in ACL reconstruction are comparable clinically and there is no advantage of one particular method over other.