Rotational muscle strength of the limb after anterior cruciate ligament reconstruction using semitendinosus and gracilis tendon

Segawa, Hiroyuki; Omori, Go; Koga, Yoshio; Kameo, Touru; Iida, Satoshi; Tanaka, Masaei

doi:10.1053/jars.2002.29894

Cited by 118 publications

(128 citation statements)

References 17 publications

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“…We found a flexion strength deficit after hamstring harvest but no difference in knee flexion strength between the graft groups when the ACL reconstructed limb was compared to the healthy non injured limb, which is consistent with previous publications [10,11]. The replication of these findings indicates that the additional harvesting of the gracilis graft does not result in greater hamstring strength deficits.…”

Section: Discussionsupporting

confidence: 92%

“…Some authors recommend harvesting only the semitendinosus tendon to minimise morbidity [8,9]. Others have not found any significant differences in hamstring strength during flexion when a harvest of both the semitendinosus and gracilis tendons (ST/G) was compared with a harvest of only the semitendinosus tendon (ST) [10,11]. In theory, the four-strand ST graft could provide better stability in translation and rotation due to its larger diameter and greater stiffness compared to the ST/G [1].…”

Section: Introductionmentioning

confidence: 99%

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Hamstring tendon anterior cruciate ligament reconstruction: does gracilis tendon harvest matter?

Barenius

Webster

McClelland

et al. 2012

International Orthopaedics (SICOT)

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Purpose Hamstring tendon grafts are a popular choice for anterior cruciate ligament (ACL) reconstruction. Typical morbidity reported after hamstring tendon harvest is muscle weakness in flexion, and whilst still a matter for debate, this morbidity may be greater if the gracilis tendon is harvested in addition to the semitendinosus. This study sought to comprehensively compare the outcome of ACL reconstructions in which the semitendinosus was harvested alone (ST group) or with the gracilis (ST/G group). Methods Twenty patients (ten ST, ten ST/G) were assessed with a variety of measures that included subjective scores, function, strength and tibial rotation as measured by gait analysis during a pivoting task. Results Results showed that the graft diameter was significantly larger in the ST group, but there were no other differences between the groups for any other outcome measure. Conclusion Harvesting the gracilis in addition to semitendinosus does not appear to affect either the outcome or graft-related morbidity after hamstring ACL reconstruction.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Hamstring tendon anterior cruciate ligament reconstruction: does gracilis tendon harvest matter?

Barenius

Webster

McClelland

et al. 2012

International Orthopaedics (SICOT)

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“…This may improve the postoperative lower extremity knee flexor and internal rotator strength as compared with harvesting both the semitendinosus and gracilis tendons, which can be deficient even at 2 years postoperatively. [46][47][48][49][50][51][52][53][54][55][56][57][58] This technique is less anatomy distorting than the iliotibial band reconstruction technique, with lower postoperative morbidity. The sockets used with this technique are all epiphyseal and blind ended with a cortical bone bridge of at least 7 mm.…”

Section: Discussionmentioning

confidence: 97%

All-Epiphyseal, All-Inside Anterior Cruciate Ligament Reconstruction Technique for Skeletally Immature Patients

McCarthy

Graziano

Green

et al. 2012

Arthroscopy Techniques

106

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Anterior cruciate ligament (ACL) injuries are an increasingly recognized problem in the juvenile population. Unfortunately, outcomes with conservative treatment are extremely poor. Adult reconstruction techniques are inappropriate to treat skeletally immature patients because of the risk of physeal complications, including limb-length discrepancy and angular deformities. "Physealsparing" reconstruction techniques exist, but their ability to restore knee stability is not well understood. We describe an all-epiphyseal ACL reconstruction for use in skeletally immature patients. This is an all-inside technique with the femoral tunnel drilled retrograde and the tibial tunnel drilled retrograde; both tunnels are entirely within the epiphysis. Fixation of the hamstring autograft is achieved with soft-tissue buttons on both the femur and tibia. We present case examples for 2 patients who underwent the all-inside, all-epiphyseal reconstruction and our postoperative rehabilitation protocol. We present a novel surgical technique for an all-inside, all-epiphyseal ACL reconstruction in skeletally immature patients.

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“…Both for internal rotation [ 29 ] and deep knee fl exion [ 34 ], there are reports of more strength defi cit after harvesting both ST and G tendons compared with only the ST tendon. Tashiro et al [ 34 ] who are one of the few conducting a randomized prospective study reported a signifi cant weakness up to 30 % in muscle strength at knee fl exion angles greater than 70°.…”

Section: Loss Of Strength and Morbidity Following Harvest Of The Tendonsmentioning

confidence: 99%

Semitendinosus and Gracilis Tendon Regeneration Following Harvest

Åhlén

Lidén

Kartus

2014

Anterior Cruciate Ligament Reconstruction

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Studies have shown that the semitendinosus (ST) and gracilis (G) tendons are able to regenerate after harvest, and probably they are the only known tendons in the human body that can regenerate after harvest of the whole tendon from the musculotendinous junction all the way to the insertion. This chapter will focus on the existing knowledge about the ST and G tendon regeneration frequency, quality of the regenerated tendon, level of insertion, cross-sectional area and weakness in fl exion and internal rotation of the knee after harvest. What the Diagnostic Methods Have Shown: The Regeneration Rate and MorphologyIn 1992 Cross et al. [ 6 ] were the fi rst to report that the ST and G tendons could regenerate after examining patients with magnetic resonance imaging (MRI). These fi ndings have subsequently been verifi ed using MRI [ 2 , 5 , 7 , 9 , 13 , 18 , 28 , 30 , 33 ]

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Rotational muscle strength of the limb after anterior cruciate ligament reconstruction using semitendinosus and gracilis tendon

Cited by 118 publications

References 17 publications

Hamstring tendon anterior cruciate ligament reconstruction: does gracilis tendon harvest matter?

Hamstring tendon anterior cruciate ligament reconstruction: does gracilis tendon harvest matter?

All-Epiphyseal, All-Inside Anterior Cruciate Ligament Reconstruction Technique for Skeletally Immature Patients

Semitendinosus and Gracilis Tendon Regeneration Following Harvest

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