Tendon-to-bone healing of a quadrupled hamstring tendon graft fixed with biodegradable screws in an immature athlete: A radiologic, arthroscopic, histologic, and electromicroscopic investigation

Abstract

Quadrupled hamstring tendon is one of the most commonly used ligamentous substitutes in anterior cruciate ligament reconstruction. We describe a case of a young athlete who sustained a rerupture of a semitendinosus-gracilis autograft fixed with biodegradable screws 2 years after primary surgery. Radiologic, arthroscopic, histologic, and electromicroscopic investigation showed tendon-to-bone healing of the soft tissue graft and partial degradation of the interference screws.

Increased Risk of Revision With Hamstring Tendon Grafts Compared With Patellar Tendon Grafts After Anterior Cruciate Ligament Reconstruction

“…For samples examined in HT reconstructions, healing with an indirect insertion was reported when interference screws were used as fixation in the tibial tunnel [257][258][259] and femoral tunnel [260,261]. When a suspensory fixation was used in the femur, either partial or complete tendon-to-bone healing were reported [255,262].…”

Tendon Healing in Bone Tunnel after Human Anterior Cruciate Ligament Reconstruction: A Systematic Review of Histological Results

“…Potentially relevant studies identified and screened for retrieval were retrieved for further evaluation. [15][16][17][18][19][20][21][22][23][24][25] One study was excluded because of no histology on tendon-bone interface. 25 Two articles were excluded due to allografts used.…”

“…26,27 Finally, 10 studies were included in this systematic review. [15][16][17][18][20][21][22][23]26,27…”

“…Five studies were conducted in European countries, 17,18,20,21,23 two in North American countries, 16,27 two in Australia, 15,22 and one in Korea. 26 Thirty-seven cases were extracted from the included studies.…”

“…Seven of 10 studies reported the age of the patients, with a range of 14 to 42 years old. 17,[20][21][22][23]26,27 The interval between ACL reconstruction and biopsy ranged from 6 weeks to 3 years. The surgical techniques were variable among the included studies.…”