The effects of hamstring harvesting on outcomes in anterior cruciate ligament-reconstructed patients: a comparative study between hamstring-harvested and -unharvested patients

Abstract

Purpose: The purpose of this study was to evaluate the effects of hamstring harvesting in patients after anterior cruciate ligament (ACL) reconstruction by comparing groups with and without hamstring harvesting.

Methods: We evaluated the effect of hamstring harvesting in 73 consecutive patients who underwent ACL reconstruction: 39 patients whose hamstrings were harvested for autografts (group H) were compared with 34 patients who received allografts during the same time period (group C [control]). The cases and controls were compared by analyzing the following variables: age, height, weight, mean follow-up period, type of tissue used, and meniscal surgery. Outcomes were assessed by the Lysholm knee score, Tegner activity score, and KT-2000 side-to-side difference (MEDmetric, San Diego, CA), as well as functional performance tests. The flexor deficit and isokinetic peak torque for knee flexion were measured in the sitting position (0° to 90°), and the flexion torque at 90° was measured in the prone position (60° to 120°).

Results: Although significant knee flexion weakness after ACL reconstruction was observed, a significantly greater knee flexor deficit was found in autograft patients than in allograft patients (P < .001). No differences were found between groups in terms of clinical and functional results regardless of hamstring harvesting. The performance of both study groups in all 4 functional tests were significantly correlated with flexor deficit in the sitting position (P < .05) but not in hyperflexion. Significant flexor deficits in both normal and hyperflexed positions were noted in both groups when compared with the unaffected knee (group H, P < .001; group C, P = .002).

Conclusions: These results indicate significant knee flexion weakness compared with the unaffected knee after ACL reconstruction regardless of hamstring harvesting. Moreover, the greater increase in knee flexor deficit in the hamstring-harvested group compared with the allograft group was statistically significant. However, clinical and functional outcomes were similar between the groups.

Level of evidence: Level III, case-control study.