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Hamstring function 2 years following anterior cruciate ligament reconstruction using semitendinosus-gracilis autografts (SS-11)

      This retrospective study evaluated the 2 year outcomes (25.8 ± 5 months postsurgery) of 20 patients post-unilateral ACL reconstruction using semitendinosus-gracilis autografts with EndoButton femoral and interference screw-staple tibial fixation. Patients underwent clinical examination including instrumented manual muscle testing of isometric knee flexion-internal rotation torque, conventional and prone isokinetic hamstring torque testing (60° and 180° per second), hop testing, knee arthrometry, modified VAS leg sensation evaluation, IKDC Subjective Knee Evaluation and IKDC Current Health Evaluation. One-way ANOVA were used to evaluate side-to-side differences and multiple regression analysis related these findings to knee function (P < .05). Patient activity levels were 6 = competitive, 6 = frequently sporting, 7 = sporting sometimes, and 1 = non-sporting. Involved side knee laxity was 66.7 N (1 ± 1 mm), 89 N (2 ± 2 mm) and 133.4 N (2.7 ± 2.5 mm), respectively. Involved side active knee flexion was decreased 8.2 ± 5°. Peak isokinetic hamstring torque did not display significant side-to-side differences. Involved side isokinetic hamstring work was decreased 76.7 ± 118 J at 60° sec during conventional testing and was decreased 94.4 ± 107 J and 86.3 ± 115 J at 60 ° sec and 180° sec, respectively during prone testing. Isometric testing revealed decreased involved side hamstring torque at 90° flexion-neutral tibial rotation (17 ± 14 Nm), at 120° flexion-neutral tibial rotation (24.5 ± 14 Nm), at 90° flexion-internal tibial rotation (13.2 ± 12 Nm), and at 120° flexion-internal tibial rotation (23.9 ± 15 Nm). Forward and medial hop tests failed to identify significant differences between extremities. Lateral hopping revealed a 4.9 ± 13 cm involved side decrease. IKDC Subjective Knee Evaluation scores were 86.4 ± 11. Current Health Assessment physical function subscale scores were 94.2 ± 6. Sensation scores were 7.6 ± 2.3 (range = 2–10). Multiple regression revealed that involved side prone isokinetic hamstring work at 60° sec and patient activity level predicted 68% of lateral hop performance (R2 = 0.68). Involved side sensation score and prone isokinetic hamstring work at 60° sec predicted 61% of medial hop performance (R2 = 0.61) and isometric hamstring torque at 90° knee flexion predicted 42% of forward hop performance (R2 = 0.42). Prone isokinetic hamstring work at 60° sec, isometric hamstring torque at 90° flexion, and sensory score were related to patient function at 2 years following ACL reconstruction using a hamstring autograft.