Observations on arthroscopic trans-portal single bundle quadrupled hamstring auto graft reconstruction with aperture fixation for complete acl disruption

Aims and Objectives: to observe and evaluate the efficacy of aperture fixation for complete ACL rupture by arthroscopic tans-portal single bundle quadrupled hamstring auto graft reconstruction. Materials and Methods: Quadrupled hamstring auto graft prepared was secured using femoral interference screw via the anteromedial port with knee in hyperflexion to ensure absolutely parallel screw placement. Tibial interference screw was placed with knee in full extension and graft under longitudinal traction to prevent proximal migration during screw advancement. Results: The Lysholm functional score improved from a mean pre-operative value of 55.23 (range 36 – 77) to 89.88 at six months (76-96) and improved to 93.8(range 80 – 98) at final follow up. The Tegner activity level improved from a mean pre-operative value (post injury) of 3.13 (range 2 – 4) to mean postoperative value of 5.13 at six months to 6.3 (range 4 – 8) at final follow up. The single leg hop test measurements improved from a mean preoperative value of 57.2% (range 40 – 71) to 86.76 at six months and 90.5 (range 79 – 98) at final follow up assessment. Discussion and Conclusion: ACL reconstruction using quadrupled hamstring auto graft and interference screw fixation is safe and highly successful with very few complications. Accelerated rehabilitation is possible in view of strong fixation of graft using interference screws.