Prospective study of use of single bundle 6 fold grafttendon for ACL reconstruction Clinical and functional outcome with analysis of factors affecting outcome.

Currently double, triple and quadruple grafts are most commonly used. We hypothesize that by further increasing the folds and using a six fold tendon graft will improve outcome. Also a six fold graft will have a larger cross sectional area and will be biomechanically more strong thus improving the knee stability

A prospective cohort study was conducted between period of June 2007 to December 2009. 153 patients undergoing ACL reconstruction were screened and 78 patients fulfilling the inclusion exclusion criteria were selected. Mean age at the time of surgery was 30.62 7.49 years (16 to 51 years). Patients were followed for a period of 18 2 months (14 to 19 months). At final follow up patients were evaluated using IKDC scoring and lysholm scoring system.

Average post operative range of motion (ROM) in degree was 139.10 3.58. At the mean time of 12 months follow-up, evaluation of anterior-posterior knee laxity with standard laxity test (anterior drawer and Lachmann test) show significant decreasing knee laxity postoperatively. According to IKDC grade system 70 patients were graded as A level and 8 patient as B level. Patients were evaluated with two scoring system, IKDC subjective form (2000 edition) and modified Lysholm score. Postoperative Lysholm score was improved to 88.17 4.43 than preoperative score 37.39 3.58, and IKDC score was improved to 87.53 2.90 from preoperative score of 34.35 2.54. All the patients returned to their preinjury activity level at the end of 6 to 8 months

The present results show that increasing cross-sectional area of hamstring tendons by using 6-strand graft can improve knee stability and reflected by the patient's activity in the early clinical outcomes. However, there are no differences in terms of subjective assessment.

Prospective case series