Anterior cruciate ligament reconstruction with doubled semitendinosus and gracilis tendon graft in rugby players

The purpose of this study was to evaluate prospectively the results of anterior cruciate ligament (ACL) reconstruction with doubled hamstring tendon graft in a selected group of 18 rugby players. The graft was fixed with a transcondylar screw (Transfix) on the femur, and with an absorbable interference screw and a metallic staple on the tibia. All the patients followed the same rehabilitation program. Return to sports activities was allowed after 6 months. Follow-up was 2 years in all cases. The athletic level of the patients was rated according to the Tegner scoring system. Clinical results were evaluated using the International Knee Documentation Committee (IKDC) scoring system. Furthermore, an instrumented evaluation of the anterior laxity with a KT–1000 arthrometer, and an isokinetic evaluation were performed 6 and 24 months after surgery. The Tegner mean score at follow-up (8.2) was similar to that prior to injury (8.3). IKDC overall results were normal in ten cases (55.6%), nearly normal in six cases (33.3%), and abnormal in two cases (11.1%). Side-to-side difference of anterior laxity measured with KT–1000 at 6 and 24 months did not show an impairment of knee stability with time. Isokinetic evaluation showed a significant improvement on peak torque both in extension and flexion on comparison between 6- and 24-month measurements. The results reported in this study showed that the use of doubled hamstring tendon graft for ACL reconstruction in athletes that were at risk for high-energy traumas to the knees, such as rugby players, gave normal or nearly normal results in about 90% of the cases. Recovery of muscle strength was almost complete 2 years after surgery, and there was no impairment of knee stability with time.