Abstract

Purpose: Two techniques of anterior cruciate ligament (ACL) reconstruction using hamstring tendons are compared: a technique using only the semitendinosus tendon (ST4) with a specific fixation using the TLS system (Tape Locking Screw©–FH Orthopaedic©) and a technique using the semitendinosus and gracilis tendons (STG) with conventional fixation (femoral endobutton and tibial interference screw).

Materials and method: A retrospective study was conducted in the orthopaedic department of a french military hospital between January 2014 and March 2016. All of the patients who were treated with ACL ligamentoplasty to the pes anserinus tendons were included. They were divided into two groups according to the technique used: ST4 or STG. The results were evaluated through an isokinetic muscle test at 6 months, then using the IKDC score at 6, 12, and 18 months.

Results: Sixty-nine patients were included: 36 in the ST4 group and 33 in the STG group. The hamstring deficit (H) was 19.5% in the ST4 group, and 21.3% in the STG group. The quadriceps deficit (Q) was 9% in the ST4 group, and 10.8% in the STG group. The IKDC score at 12 months was 87.2 in the ST4 group, and 85.5 in the STG group. No significant differences were shown between the two groups.

Conclusion: The functional results appear to be slightly better in the ST4 group, though not to a significant level. The isokinetic H/Q ratio and the conditions of resuming sports practice were satisfying and comparable in both groups. ACL ligamentoplasty using only the semitendinosus tendon seems to be reliable, even for military patients who are subject to specific operational constraints.

Keywords: Isokinetics; Semitendinosus; Anterior cruciate ligament; Military