Effect of anterior cruciate ligament reconstruction with hamstring tendons on Insall-Salvati index and anterior knee pain

Abstract

Introduction/Objective. The aim of this study was to evaluate the relationship between anterior knee pain and Insall-Salvati ratio after anterior cruciate ligament (ACL) reconstruction with hamstring tendon. Methods. We have evaluate 39 patient that had an ACL reconstruction surgery with hamstring tendon retrospectively. 14 patient had anterior knee pain at the and of the first year of the surgery. All the patient were evaluated for Insall-Salvati ratio preoperatively and postoperatively. Patients were evaluated at the end of the first year after the surgery with Lysholm score and Tegner activity scale. Patients preoperative and postoperative measurements were analyzed by using the Wilcoxon test and differences between patients with anterior knee pain and without pain was analyzed by the Mann-Whitney U test. Results. Mean Insall-Salvati ratio was found preoperatively 0,91±0,1 and postoperatively 0,85±0,09 (p≤0,05). Mean Tegner activity score was 8,56±1,04 and mean Lysholm score was 87,36±9,42 in the group without anterior knee pain. Mean Tegner activity score was 7,21±0,97 and mean Lysholm score was 74,43±9,94 in the group with anterior pain. There is an decrease in İnsall-Salvati ratio as a result of the surgery. But patients with anterior knee pain had lower values of İnsall-Salvati ratio preoperatively. Conclusion. Preoperatively low İnsall-Salvati ratio can be premised indicator of anterior knee pain in the early period after ACL reconstruction with hamstring tendons. Mean Tegner activity score and mean Lysholm score have higher values in the group without anterior pain post operatively.

Keywords

• anterior cruciate ligament
• reconstruction
• Insall-Salvati Index
• hamstring tendons