Graft Site Morbidity with Autogenous Semitendinosus and Gracilis Tendons

Abstract

To distinguish between morbidity caused by harvesting semitendinosus and gracilis tendons and morbidity associated with anterior cruciate ligament reconstruction surgery, we performed a prospective randomized study using 65 patients who underwent anterior cruciate ligament reconstruction using these tendons. The patients underwent either contralateral (N = 34) or ipsilateral (N = 31) graft harvest. For the nonoperated knees in the ipsilateral harvest group, isometric and isokinetic strength of the quadriceps and hamstring muscles increased to approximately 120% of the preoperative value at 12 months after surgery. Compared with these knees, the tendon harvest did not affect quadriceps muscle strength at all. However, harvest did decrease hamstring muscles strength for 9 months after surgery. The graft harvest in the knees with anterior cruciate ligament reconstruction also did not significantly affect quadriceps muscle strength, but it did significantly decrease hamstring muscles strength only at 1 month. Activity-related soreness at the donor site was rarely restricting and resolved by 3 months. This study demonstrated that the semitendinosus and gracilis tendon graft is a reasonable choice to minimize the donor site morbidity in ligament reconstruction using autografts.

Effects of aggressive early rehabilitation on the outcome of anterior cruciate ligament reconstruction with multi-strand semitendinosus tendon

“…Experiments with the tendon of beagle dogs showed similar levels of failure with three difference methods of fixation [11,27,28], with the grafts always failing at the interface between the tendon and the fixation material.…”

“…The volume of the STG graft is greater than that of the BTB [12,17,27], but the difference in the procedures appears to be in the healing which takes place within the bony tunnel. In the STG procedure anchoring begins at the interface of the tendon and the bone and experience has suggested that tendon anchoring takes longer to become sound than bone to bone fixation [14].…”

“…ACL reconstruction using the STG technique needs improvements in the technique of operation before it can be considered as a true alternative to BTB reconstruction [26,27]. However, it is uncertain as to how the two compare.…”

Arthroscopic single-bundle posterior cruciate ligament reconstruction: retrospective review of hamstring tendon graft versus LARS artificial ligament

“…Bone-patellar tendon-bone (BPTB) and hamstring tendon autografts are the most commonly used grafts of choice today. Nevertheless, reports of donor-site morbidity have increased [2,3] and the use of artificial ligaments which avoids those complications may offer an alternative form of treatment. The LARS artificial ligament (Ligament Advanced Reinforcement System, Surgical Implants and Devices, Arc-sur-Tille, France) has recently been reported to be a suitable material [4][5][6][7].…”

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION & THE HAMSTRINGS Implications for injury prevention & rehabilitation

“…Most studies report deficits in quadriceps and hamstring strength after ACLR, and in many cases, these deficits persist well after the cessation of rehabilitation (Pinczewski et al, 2007;Yasuda, Tsujino, Ohkoshi, Tanabe, & Kaneda, 1995).…”