Intra- and extra-articular anterior cruciate ligament reconstruction utilizing autogeneous semitendinosus and gracilis tendons: 5-year clinical results

Knee Surg Sports Traumatol Arthrosc. 2003 Jan;11(1):2-8. doi: 10.1007/s00167-002-0323-x. Epub 2002 Dec 18.


This prospective study examined 50 patients who underwent ACL surgery using hamstring tendons with a modification including intra- and extra-articular reconstruction. All patients were athletes competing at a high level in various sports. Full return to sports was allowed at 4 months. IKDC score and KT-2000 were used for assessing clinical outcome at a mean of 6.4 years (5-7 years) Resumption of sport, Tegner activity score, and isokinetic test were also used. The IKDC score showed 92% of normal or nearly normal knees. Of the 50 patients 48 regained full extension, and only two had extension deficit between 0 degrees and 3 degrees. KT evaluation was less than 3 mm in 38 cases (76%), 3-5 mm in 9 (18%), and more than 5 mm in 3 (6%). In 90% of cases the patient resumed sport at the same level. The mean Tegner activity score was 8.1 (5-10). The isokinetic test showed no deficit for hamstring and quadriceps muscles. Removal of staples was necessary in eight cases (16%) due to femoral lateral bursitis. Acute reconstruction had significantly better clinical assessment of abnormal laxity and KT value. Men had significantly better results then women. This technique demonstrated a high reliability, low morbidity, low functional deficit and fast recovery using hamstring grafts.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Analysis of Variance
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Injuries*
  • Athletic Injuries / surgery*
  • Chronic Disease
  • Female
  • Functional Laterality
  • Humans
  • Joint Instability / surgery
  • Knee Joint / innervation
  • Knee Joint / physiopathology
  • Knee Joint / surgery*
  • Linear Models
  • Male
  • Pain / etiology
  • Paresthesia / etiology
  • Postoperative Complications
  • Prospective Studies
  • Range of Motion, Articular / physiology
  • Recovery of Function
  • Regression Analysis
  • Sex Factors
  • Tendons / transplantation*
  • Treatment Outcome