• Journal of the Korean Arthroscopy Society
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• v.14 no.2
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• pp.92-101
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• 2010

The Hamstring autograft and the bone patellar bone tendon autograft have been widely used for anterior cruciate ligament reconstruction. In recent years, use of hamstring autograft for ACL reconstrution has been increased. The reason seems to be the advantages of the hamstring tendon such as high ultimate tensile load, low donor site morbidity and development of graft fixation method. These theoretical advantages have been increased as studies have shown that hamstring tendons actually regenerate after harvesting for ACL reconstruction. However, the concerns have arisen regarding the disadvantages of hamstring harvest, which were weakness of tibial internal rotation, the loss of flexion strength. The flexion strength loss has been controversial, therefore it needs to study whether restoration of flexion strength after hamstring regeneration is or not. In this study, we reviewed the current research of concerns on the advantage and disadvantage of hamstring tendon autograft and the hamstring regeneration. Furthermore, we compared the earlier studies and experiences regarding Hamstring regeneration with our research.

• Journal of the Korean Arthroscopy Society
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• v.12 no.1
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• pp.7-11
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• 2008

Purpose: The purpose of this study was to compare the clinical outcomes of ACL reconstruction using autogenous hamstring tendon and allo-tibialis tendon. Materials and Methods: Between March 2002 and March 2005, We performed 30 ACL reconstuructions using hamstring autograft and 20 ACL reconstuructions using tibialis tendon allograft. The average follow up period was 22 months in auto-hamstring tendon and 18 months in allo-tibialis tendon. For the clinical evaluation, we measured the Lysholm score, International Knee Documentation Committee(IKDC) score and anterior laxity by KT-2000 arthrometer at final follow up and compare the results between two groups. Results: The Lysholm score improved from 69.5 preoperatively, to 95.3 at final follow-up in the hamstring autograft groups and from 69.0 to 90.4 in the tibialis allograft groups. According to the IKDC evaluation form, 80% of autogenous hamstring tendon group and 73% of allograft group were good results, higher than B(almost normal)(p>0.05). The average KT-2000 arthrometer side-to-side difference, decreased from 7.1mm preoperatively, to 1.8mm at final follow-up in the hamstring autograft groups and from 7.4 mm to 2.4mm in the tibialis allograft groups. Conclusion: The clinical results of ACL reconstruction using auto-hamstring tendon and allo-tibialis tendon showed no significant differences. The allo-tibialis tendon is an acceptable substitute for auto-hamstring tendon in ACL reconstruction.

• 대한정형외과스포츠의학회:학술대회논문집
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• 2004.09a
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• pp.20-21
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• 2004

• Journal of Korean Orthopaedic Sports Medicine
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• v.10 no.1
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• pp.18-26
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• 2011

Purpose: This study is to compare the clinical results of ACL reconstruction between three groups using hamstring tendon autograft, mixed and tibialis tendon allograft. Materials and Methods: Between August 2003 and August 2008, we analyzed 169 cases of ACL reconstruction, 66 cases used hamstring tendon autograft, 42 cases used mixed graft and 61 cases used tibialis tendon allograft, with a minimum follow-up of 12 months. For the clinical evaluation, we evaluated the Lysholm score, Telos stress test device and IKDC score. Results: The average side to side difference in Telos stress test decreased from $7.5{\pm}1.0$ mm to $1.6{\pm}1.0$ mm in autograft group, from $7.6{\pm}1.1$ mm to $1.4{\pm}1.1$ mm in mixed graft group and from $7.4{\pm}1.3$ mm to $2.5{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from 58.6 to 92.3 in autograft group, from 60.6 to 92.6 in mixed graft group and from 55.3 to 91.5 in allograft group. There was no significant difference between three groups in clinical results. At second look arthroscopy, tension of ligament and synovial coverage were good result in autograft and mixed graft than allograft group. Conclusion: All hamstring tendon autograft, mixed graft and tibialis tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. Both hamstring tendon autograft and mixed graft showed good synovial coverage in second look arthroscopy. So mixed graft will be considered as good alternative in case of shorter or thin harvested hamstring tendon.

• Journal of the Korean Arthroscopy Society
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• v.11 no.2
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• pp.85-91
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• 2007

Purpose: To analyze the clinical results and second look arthroscopic findings of anterior cruciate ligament(ACL) reconstruction with a tibialis anterior tendon allograft and a hamstring tendon autograft. Materials and Methods: We reviewed the cases of athroscopic ACL reconstructions using allogenous tibialis anterior(TA) tendon and autogenous hamstring tendon done from March, 2002 to August, 2005 and followed-up more than 1 year. The 250 cases were included in this study and allogenous TA tendon was used in 150 cases and autogenous hamstring tendon in 100 cases. The mean follow-up period was 15 months and 14 months, respectively. The clinical evaluation was done by Lachman test, Pivot shift test, KT-1000 arthrometer and International Knee Documentation Committee(IKDC) knee score. Graft tension, synovial coverage were observed in cases of second look arthroscopy. Results: At final follow-up, there was no significance between the two groups in clinical examination. On second look arthroscopy, synovial coverage was better in autogenous hamstring tendon group than allogenous TA tendon group(p=0.005). But no difference was found in graft tension(p>0.05). Conclusion: There were no significant differences between the two groups in the clinical results. But autogenous hamstring tendon group had better synovial coverage than allogenous TA tendon group in second look arthroscopy.

• Journal of Korean Orthopaedic Sports Medicine
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• v.8 no.2
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• pp.109-114
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• 2009

Purpose: The purpose of this study is to compare the clinical results of ACL reconstruction between two groups using hamstring tendon autograft and tibialis anterior tendon allograft. Materials and Methods: Between January 2006 and June 2007, we analyzed 68 cases of ACL reconstruction, 32 cases using hamstring tendon autograft and 36 cases using tibialis anterior tendon allograft, with a minimum follow-up of 24 months. For the clinical evaluation, we evaluated the Lysholm score, anterior laxity by Telos device and KT-2000 arthrometer. Results: The mean diameter of graft were 8.0 mm (7.0~9.0 mm) in autograft group and 9.1 mm (8.0~10.0 mm) in allograft group. In all cases, the range of motion was above 135 degrees. The average side to side difference in Telos stress test decreased from $7.3{\pm}1.0$ mm to $2.4{\pm}1.1$ mm in autograft group and from $7.4{\pm}1.2$ mm to $2.3{\pm}1.3$ mm in allograft group. The average Lysholm knee score improved from $72.6{\pm}3.4$ to $92.3{\pm}3.5$ in autograft group and from $72.3{\pm}3.5$ to $91.6{\pm}3.3$ in allograft group. There was no significant difference between two groups in clinical results. Conclusion: Both hamstring tendon autograft and tibialis anterior tendon allograft groups showed satisfactory clinical results, with no significant difference in outcomes between the groups. We suggest that both hamstring tendon autograft and tibialis anterior tendon allograft will be considered as acceptable graft for anterior cruciate ligament reconstruction.

• Journal of the Korean Arthroscopy Society
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• v.10 no.2
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• pp.141-147
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• 2006

Purpose: To compare the clinical and radiological results of anterior cruciate ligament(ACL) reconstruction using hamstring autograft and tibialis tendon allograft. Materials and Methods: Twenty four ACL reconstructions using hamstring autograft and 30 using tibialis anterior tendon altograft were followed up at least 1 year. We performed femoral tunnel fixation with Ligament Anchor(LA) screw and tibial tunnel fixation with biodegradable interference screw. Evaluations included Lysholm knee(LK) score, Tegner activity scale, Lachman test, Pivot-Shift test, Quardriceps atrophy, incision site numbness, anterior knee pain and instrumented anterior laxity with $Telos^{(R)}$ device. Results: Preoperativ mean LK score was $60.3(18{\sim}82)$ in autograft group and 61.2(25-80) in allograft group. Mean LK score improved to $91.6(68{\sim}100)\;and\;92.6(77{\sim}100)$ respectively. Activity level, using Tegner activity scale, slightly decreased compared with that of Preinjury state in both groups. Lachman test, pivot-shift test, Quadriceps atrophy, anterior knee pain, incision site numbness, and anterior drawer test using $Telos^{(R)}$ device showed no significant difference between two groups (p>0.05). Conclusion: In performing the ACL reconstruction, there was no statistically significant difference between hamstring autograft group and tibilis anterior allograft group in clinical or in radiological results.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.1
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• pp.38-44
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• 2007

Purpose: To evaluate status of reconstructed ACL and changes around graft through second-look arthroscopy after arthroscopic reconstruction of the ACL with autograft tendons. Material and Methods: Between Jun. 2003 and Feb. 2007, the second look arthroscopy was performed on 22 cases. Second-look arthroscopy was conducted on average 15.1 $(7\sim31)$ months after reconstruction. 15 cases received hamstring tendon autograft, 7 cases received bone-patellar tendonbone autograft. We measured graft tension using displacement by probing, synovial coverage by visual analysis at second-look arthroscopy The assay in Lysholm score, Lachmann test and KT-2000 arthrometer were evaluated status of reconstructed ACL. Results: The hamstring tendon group showed normal tension in 11 cases and lax tension in 4 cases. The patellar tendon group showed normal tension in 3 cases, lax tension in 2 cases and partial tear in 2 cases. In the hamstring tendon group, synovial coverage was good in 11 cases, half in 3 cases and pale in 1 case, and the bone-patellar tendon-bone group was good in 4 cases and half in 3 cases. The patellar tendon group was superior to the hamstring tendon group in Lysholm score (p<0.05), but insignificance difference in KT-2000 arthrometer results statistically. Conclusion: The hamstring tendon group was superior to the bone-patellar tendon-bone group in second-look arthroscopy after ACL reconstruction with autograft tendons results, but long term follow up will be necessary to further evaluated.

• Journal of the Korean Arthroscopy Society
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• v.3 no.2
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• pp.91-96
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• 1999

Purpose : The purpose of this study is to compare the clinical and radiologic results of the anterior cruciate ligament(ACL) reconstruction using bone-patellar tendon-bone unit with doubled semitendinosus and gracilis tendons. Materias and Methods : Clinical results of ACL reconstructions which were performed in 47 patients using doubled semitendinosus and gracilis were compared with those performed in 45 patients using bone-patellar tendon-bone autograft. There were no differences in preoperative parameters(age, sex, instability). Average follow-up period were 17 months and 19 months each. Results : There were no significant differences between two groups in functional results (Lysholm knee score), degree of laxity and range of motion at final follow-up. However, the parapatellar complication, especially anterior knee pain after long distance walking or exercise and quadriceps weakness less occurred in hamstring tendon group than in bone-patellar tendon-bone group. Conclusion : Although there were no significant differences in clinical results of ACL reconstruction using bone-patellar tendon-bone autograft and doubled semitendinosus and gacilis, parapateller complications occurred more in the bone-patellar tendon-bone autograft group than in the doubled semitendinosus and gracilis group. It is thought that the careful selection of patient, achivement of skillful technique and active rehabilitation are important to prevent the parapatellar complications.

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.1
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• pp.56-59
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• 2004

The hamstring tendons are popular for autografts in a variety of reconstructive procedures. The hamstring autografts are used widely for its potential advantages over the patella bone-tendon-bone(BTB) autograft, including lower graft site morbidity and easier harvesting technique. However, the use of hamstrings has potential disadvantages such as the damage of infrapatellar branches of the saphenous nerve, premature tendon amputation, and tendon split following inadequate hamstring identifications. In our studies, we used modified technique for harvesting the hamstring to decrease potential disadvantages. Reflected hamstring flap method seems to be easy and safe in avoiding nerve damage and tendon splitting. We recommend the reflected hamstring flap method for harvesting hamstring tendons.