Functional Effects of Single Semitendinosus Tendon Harvesting in Anatomic Anterior Cruciate Ligament Reconstruction: Comparison of Single versus Dual Hamstring Harvesting

Abstract

Background This study aimed to determine the effects of single semitendinosus tendon (ST) harvesting for anterior cruciate ligament (ACL) reconstruction by comparing outcomes of single ST and semitendinosus-gracilis tendon (ST-G) harvesting. Methods ACL reconstruction with ST-G harvesting (D group, n = 60) or single ST harvesting (S group, n = 60) were included according to inclusion criteria. Subjective assessments included subjective International Knee Documentation Committee score, Lysholm score, and Tegner activity scale score. Objective assessments included isokinetic strength and functional tests. These tests were completed at 36 months of follow-up. Magnetic resonance imaging (MRI) and second-look arthroscopy findings were evaluated. In the S group, regeneration properties were assessed by serial ultrasonography (US). Results The S group showed significantly less deep flexor strength deficit than the D group ( p < 0.001). Deep flexor power deficits showed significant correlation with the shift of musculotendinous junction of the ST. There was significant difference in the cocontraction test between the groups ( p = 0.012), and the S group tended to show better results in other functional tests at the last follow-up. There were no significant differences in graft tension and synovial coverage on second-look arthroscopy between the groups. In the S group, the regeneration rates assessed by US at the joint line and distal insertion were 81.7% and 80%, respectively at 6 months of follow-up. Conclusions The S group showed significantly less deficit in deep flexor strength and tended to show better clinical results at the last follow-up than the D group. In the S group, more than 80% showed good regeneration at the 6-month follow-up. Hence, single ST harvesting is effective in minimizing flexor weakness and functional deficits and shows great potential for regeneration.

Analysis of Risk Factors for Ramp Lesions Associated With Anterior Cruciate Ligament Injury

“…Meniscal tears are common in patients with anterior cruciate ligament (ACL) injuries and frequently occur in the posterior horn of the medial meniscus (MMPH). 1,24,42,43 Among these, peripheral lesions in the meniscocapsular zone, known as ramp lesions, are considered a subject of interest given the insufficient number of studies evaluating risk factors associated with them. 42,43 Biomechanical studies have indicated that injury to the posterior meniscocapsular zone further increases anterior tibial translation and external rotation when combined with ACL injuries.…”

Clinical and Radiological Outcomes of Meniscal Repair Versus Partial Meniscectomy for Medial Meniscus Root Tears: A Systematic Review and Meta-analysis

“…There are 2 types of medial meniscus root tears (MMRTs). 14,25,28,33 One is a trauma-related avulsion injury that occurs just at the attachment site of the insertional ligament of the meniscus root in the posterior aspect of the proximal tibia, which is rare and usually arises in younger patients. The other, more common type is a degenerative MMRT, which is related to knee osteoarthritis in elderly patients and usually occurs farther away from the meniscal insertional ligament site, thus leaving the meniscal stump in the meniscal horn area.…”

Tetiva mišića plantarisa – novi presadak i operacijska tehnika zajedničke rekonstrukcije prednjeg križnog i anterolateralnog ligamenta koljena

“…Mišići hamstringsi (semitendinozus i gracilis) agonisti su ACL-a te imaju stabilizacijsku ulogu na koljeno, posebice kod pokreta dinamičkog valgusa, pa se smatra da njihovo oduzimanje za presadak uzrokuje veći rizik za puknuće presatka ACL-a nakon njegove rekonstrukcije 58 . Upravo zbog nepovoljnog učinka na biomehaniku koljena, zbog oduzimanja obje tetive hamstringsa kod rekonstrukcije ACL-a, razvile su se nove tehnike rekonstrukcije ACL-a koje za presadak ACL-a koriste jednu tetivu hamstringsa u trostruko ili četverostruko presavijenom obliku [59][60][61] . Međutim, s pojavom tehnika zajedničke rekonstrukcije ACL-a i ALL-a potreba za dodatnim presatkom rezultirala je oduzimanjem obje tetive hamstringsa 9 .…”