Hamstring ACL Reconstruction: Advantages, Success Rates, and Potential Problems

Introduction

An ACL (anterior cruciate ligament) rupture is a common injury, particularly among athletes who engage in high-impact sports. This type of injury can cause instability, pain, and reduced range of motion in the knee, limiting a person's ability to participate in physical activities. In cases where conservative treatment is insufficient, a hamstring ACL reconstruction surgery may be recommended. One type of graft used in this procedure is a hamstring graft, which offers several advantages but also has some potential problems.

What is the hamstring muscle group?

Hamstring muscles are a group of three muscles located on the back of the thigh that play a crucial role in knee flexion and hip extension. The three muscles that comprise the hamstring group are the biceps femoris, semitendinosus, and semimembranosus. Hamstring tendons are important for a wide range of movement activities, particularly those that involve knee flexion and hip extension. These activities include walking, running, jumping, squatting, and climbing stairs, among others. Hamstring tendons work with other muscles and tendons in the leg to stabilise the knee joint and support the body's weight during movement.

Which hamstrings are used for hamstring ACL reconstruction?

The semitendinosus and the gracilis are commonly used as grafts in ACL reconstruction surgery due to their similarity in size and strength to the native ACL. During surgery, Mr Pai will harvest a portion of one or both of these tendons, which will be used to create the new ACL. Rehabilitation following ACL reconstruction with a hamstring graft typically involves exercises to strengthen the hamstring muscles and improve range of motion in the knee.

Advantages of using a hamstring graft for ACL reconstruction

Hamstring grafts involve using a portion of the patient's own hamstring tendon to create a new ligament in the knee. There are several advantages with hamstring ACL reconstruction, including:

  1. Lower risk of complications

    Hamstring grafts tend to have a lower risk of complications than other types of grafts, such as patellar tendon grafts. Specifically, there is a lower risk of postoperative knee pain, stiffness, and less risk of a fracture within the kneecap.

  2. Faster recovery time

    Because hamstring grafts are less invasive than other types of grafts, patients may experience a faster recovery time. Patients may be able to return to full activity sooner after surgery, allowing them to resume their normal routine more quickly.

  3. Better cosmetic appearance

    Because the incision for a hamstring graft is typically smaller than other types of grafts, patients may experience a more aesthetically pleasing result.

Success rates of hamstring ACL reconstruction

The success rate of hamstring ACL reconstruction is generally high, with most patients fully recovering. According to a systematic review and meta-analysis published in the journal Orthopaedics & Traumatology: Surgery & Research, the overall success rate for ACL reconstruction with a hamstring graft is around 90%. The study also found that the rate of graft reinjury was relatively low, at around 4.3%.

Potential problems associated with a hamstring ACL reconstruction

While hamstring grafts offer many advantages for ACL reconstruction, they can also have potential problems. One of the most common issues associated with hamstring grafts is hamstring pain and weakness.

After ACL reconstruction surgery, hamstring pain and weakness can occur due to removing a portion of the patient's hamstring tendon. This can limit a patient's mobility and cause discomfort during physical activity. However, this pain and weakness are usually temporary and can be managed with physical therapy and rehabilitation exercises.

Conclusion

In conclusion, ACL reconstruction with a hamstring graft is a common and effective surgical procedure that can help patients regain stability and mobility in the knee. While hamstring grafts offer many advantages over other types of grafts, such as lower risk of complications and faster recovery time, they can also come with potential problems, such as hamstring pain and weakness. If you are considering ACL reconstruction surgery with a hamstring graft, it is important to speak with Mr Pai about the potential risks and benefits of the procedure. With proper care and attention, many patients can return to their normal activities within a few months after ACL reconstruction surgery with a hamstring graft.