Semitendinosus Tendon for ACL Reconstruction: Regrowth and Mechanical Property Recovery

Suydam, Stephen M.; Cortés, Daniel H.; Axe, Michael J.; Snyder‐Mackler, Lynn; Buchanan, Thomas S.

doi:10.1177/2325967117712944

Cited by 45 publications

(43 citation statements)

References 26 publications

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“…28 Suydam et al 28 demonstrated that less than 50% of the visco-elastic properties of the ST tendon had recovered by 12 months postoperatively, suggesting a reduced capacity to transmit muscle force across the joint. 28 An analysis of rRFD, an unbiased measure of rapid force ability, showed no difference between limb conditions. This suggests that differences in RFD ability are attributable to the between-limb absolute strength differences.…”

Section: Discussionmentioning

confidence: 99%

Joint angle‐specific impairments in rate of force development, strength, and muscle morphology after hamstring autograft

Morris

Jordan

Sumar³

et al. 2020

Transl. Sports. Med.

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The purpose of this study was to analyze the effects of anterior cruciate ligament reconstruction (ACLR) using the semitendinosus (ST) tendon autograft technique on knee flexor maximal torque and rate of torque development (RTD) in athletes who had returned to competition, and to determine the relationship between knee flexor strength deficits and hamstring muscle cross-sectional area (CSA). Fifteen athletes with ACLR (1.9 ± 0.6 years post-surgery) and non-injured, sex-matched, and sport-matched control athletes performed maximal voluntary contractions (MVC) of isometric knee flexion to obtain maximal torque (Torque max) and maximal RTD (RTD max) at 5 knee joint angles. CSA of the knee flexors was measured using ultrasound imaging. Deficits were found at all knee joint angles for Torque max and more than 70° of knee flexion for RTD max when comparing the ACLR limb to the Contralateral limb (P < .05). ST muscle CSA was lower in the ACLR limb compared with the Contralateral limb at all measurement sites (P < .01). Correlations (r = 0.6-0.9) were found between ST muscle CSA and knee flexor strength. These results suggest the importance of preserving ST muscle architecture following ACLR. Further, graft choice should be made with consideration of the specific strength requirements of the athlete's sport.

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Section: Discussionmentioning

confidence: 99%

Joint angle‐specific impairments in rate of force development, strength, and muscle morphology after hamstring autograft

Morris

Jordan

Sumar³

et al. 2020

Transl. Sports. Med.

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“…Tendon regeneration has been postulated to occur from an extrasynovial hematoma in the harvested tendon canal because hematoma acts as a scaffold for fibroblasts to invade and promote the mechanism for collagen production and tendon regeneration 13). Recently, Suydam et al25) demonstrated ST regeneration and recovery of functional biomechanical properties including shear elastic and viscous moduli with time using imaging and elastography data after ST-G harvesting. They demonstrated that the elastic modulus of the regenerated ST potentially transmitted muscle force across the joint and restored ST function.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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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.

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“…Rehabilitation clinicians should therefore monitor donor-site pain when the patient performs quadriceps strengthening exercises. After ACLR with hamstring grafts, the mechanical properties of the neo tendons may eventually recover with time [78]. To allow for healing, heavy resistance hamstring strengthening exercises are usually delayed for a period postoperatively [75], but there is no consensus on the optimal time frame for initiation of heavy resistance hamstring exercises.…”

Section: Introductionmentioning

confidence: 99%

Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture

Filbay

Grindem

2019

Best Practice & Research Clinical Rheumatology

262

191

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Anterior cruciate ligament (ACL) rupture occurs most commonly in young and active individuals and can have negative long-term physical and psychological impacts. The diagnosis is made with a combination of patient's history, clinical examination, and, if appropriate, magnetic resonance imaging. The objectives of management are to restore knee function, address psychological barriers to activity participation, prevent further injury and osteoarthritis, and optimize long-term quality of life. The three main treatment options for ACL rupture are (1) rehabilitation as first-line treatment (followed by ACL reconstruction (ACLR) in patients, who develop functional instability), (2) ACLR and post-operative rehabilitation as the first-line treatment, and (3) pre-operative rehabilitation followed by ACLR and post-operative rehabilitation. We provide practical recommendations for informing and discussing management options with patients, and describe patient-related factors associated with a worse ACL-rupture outcome. Finally, we define evidence-based rehabilitation and present phase-specific rehabilitation recommendations and criteria to inform return to sport decisions.

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Semitendinosus Tendon for ACL Reconstruction: Regrowth and Mechanical Property Recovery

Cited by 45 publications

References 26 publications

Joint angle‐specific impairments in rate of force development, strength, and muscle morphology after hamstring autograft

Joint angle‐specific impairments in rate of force development, strength, and muscle morphology after hamstring autograft

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

Evidence-based recommendations for the management of anterior cruciate ligament (ACL) rupture

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