Purpose: The hypothesis of this randomized controlled trial is patients undergoing ACL reconstruction using contralateral hamstring harvest will have better quality of life and strength than using ipsilateral graft.

Method: One hundred participants were assigned to the ipsilateral (IG) or contralateral (CG) group. Primary and secondary outcomes were ACL Quality of Life (ACL-QOL) and concentric isovelocity knee flexion/extension strength measured on a dynamometer at five speeds. Data was gathered pre-surgery, and at 3, 6, 12, and 24 months post-surgery. Findings to 12 months are presented.

Results: ACL-QOL scores and knee flexion/extension strength were not significantly different between groups across time. Comparing side-to-side strength within each group, knee extension strength was consistently higher on the non-reconstructed side. In the IG, there were no side-to-side differences in knee flexion strength. In the CG, flexion on the reconstructed side was stronger than the grafted side early post surgery (3, 6 months) at 60 degrees/s, but this pattern was reversed at 90, 150, and 210 degrees/s. Post-hoc comparisons revealed hamstring/ quadriceps (H/Q) ratios were not different between limbs in the CG or for the uninvolved limb for the IG. However, at most time points and speeds, the H/Q ratio for the involved limb in the IG was higher than the uninvolved limb in the IG and either limb in the CG.

Conclusion: This study reveals that ipsilateral graft harvest may alter the H/Q ratio. It was also demonstrated that contralateral graft harvest may normalize this effect. This may have some bearing on function and re-injury risk that should be further investigated.

Purpose: Arthroscopic stabilization for post-traumatic anterior glenohumeral instability is designed to minimize soft tissue dissection while achieving similar or improved outcomes relative to open techniques. This study’s purpose was to determine the rate of post-operative recurrent instability and evaluate health related quality of life (HRQL) and shoulder range of motion (ROM) following arthroscopic Bankart repair using a bioabsorbable knotless implant.

Method: Forty-three patients were prospectively evaluated following arthroscopic anterior stabilization to assess for recurrent instability, HRQL, and shoulder ROM. Assessments were performed pre-operatively and 3, 6 and 12–24 months postoperatively. The HRQL measures included the Western Ontario Shoulder Instability Index (WOSI), the American Shoulder and Elbow Surgeons Score (ASES), and the Constant Score. Repeated measures ANOVA was utilized to evaluate ROM and HRQL.

Results: The mean WOSI score improved from 45.67±17.99 pre-operatively to 83.16±18.58 at final follow-up. The mean ASES scores improved from 80.1±13.06 pre-operatively to 92.25±15.08, while the Constant score improved from 77.52±16.11 pre-operatively to 85.18±26.76. At final follow-up, 4 of 43 patients (9.3%) had experienced recurrent instability. For these 4 subjects, the WOSI score was significantly lower at final follow-up than those who did not experience recurrent instability (61.73±5.76 versus 84.38±16.94). The ASES and Constant scores at final follow-up were not significantly different between these two groups.

Conclusion: Arthroscopic anterior stabilization using a bioabsorable tack led to a recurrent instability rate similar to previous reports, and resulted in improved HRQL and shoulder ROM. The WOSI score was better able to detect problems in HRQL related to instability than either the ASES or Constant score.