IADMS New York 2002   [back to the Category]

Anterior Cruciate Ligament IAnterior Cruciate Ligament Injuries in Dancers: Arthroscopic Reconstruct   [read the french version]

Author :   Donald J. Rose, MD & Al.

Anterior Cruciate Ligament Injuries in Dancers:
Arthroscopic Reconstruction Utilizing Hamstring Tendons.


Donald J. Rose, MD
Harkness Center for Dance Injuries, Hospital for Joint Diseases
Brian S. DeLay, MD; Thomas Joseph, MD
NYU-HJD Department of Orthopaedic Surgery
New York, New York, USA


Anterior cruciate ligament (ACL) rupture has been an increasingly frequent injury in dancers, often jeopardizing careers. ACL injuries have been found to be 2-8X more frequent in females. The purpose of this presentation will be to discuss the etiology of non-contact ACL ruptures in dancers and the possible causes of increased frequency in females. While non-operative management has a role in both the prevention and treatment of ACL injuries in dancers, an additional focus of this presentation will be to discuss the operative management utilizing hamstring tendon reconstruction, which has recently achieved increased popularity. As all hamstring tendon reconstructions are not the same, an historical perspective will be presented. The authors’ currently utilized procedure is an arthroscopic endoscopic ACL reconstruction using quadruple-stranded semitendinosus and gracilis tendon autograft with combined cortical and intraosseous fixation. Since June 1997, >170 such reconstructions were performed, including >17 dancers. No graft failures have been noted to date. The surgical technique, as well as a 2-4 year follow-up of 50 patients will be presented. An extensive subjective and objective postoperative assessment was performed on all patients. Tegner, Lysholm and IKDC scores all improved significantly. Average knee extension and flexion loss was 1° and 3° respectively. 98% of patients had a 0 or +1 Lachman score. KT-1000 side-to-side difference averaged 1.6 mm., with a statistically significant improved scores in women (females: 0.9 mm., males: 2.0 mm.), contrary to previous hamstring ACL reports. No significant difference was noted between dancers and non-dancers. Chronicity of the injury and patient age did not significantly affect objective results. All dancers returned to dance, if desired. In conclusion, arthroscopic ACL reconstruction using a quadruple-stranded semitendinosus and gracilis tendon autograft with combined cortical and intraosseous fixation can have excellent results in the functionally unstable dancer while avoiding some of the recognized morbidity associated with other graft choices.