ACL reconstruction using a quadruple semitendinosus graft with cortical fixations gives suitable isokinetic and clinical outcomes after 2 years

Abstract

Purpose The objective of this single-center randomized single-blinded trial was to assess the hypothesis that anterior cruciate ligament reconstruction (ACLR) using a four-strand semitendinosus (ST) graft with adjustable femoral and tibial cortical fixation produced good outcomes compared to an ST/gracilis (ST/G) graft with femoral pin transfixation and tibial bioscrew fixation. Follow-up was 2 years. Methods Patients older than 16 years who underwent primary isolated ACLR included for 1 year until August 2017 were eligible. The primary outcome measures were the subjective International Knee Documentation Committee (IKDC) score, isokinetic muscle strength recovery, and return to work within 2 years. The study was approved by the ethics committee. Results Of 66 eligible patients, 60 completed the study and were included, 33 in the 4ST group and 27 in the ST/G group. Mean age was 30.5 ± 8.9 years in the 4ST group and 30.3 ± 8.5 in the ST/G group (n.s.). No significant between-group differences were found for mean postoperative subjective IKDC (4ST

Long-term quality of life, work limitation, physical activity, economic cost and disease burden following ACL and meniscal injury: a systematic review and meta-analysis for the OPTIKNEE consensus

“…Common sources of bias included insufficient study power, loss to follow-up and not accounting for confounding. Of 15 randomised controlled trials (RCTs), 9 were low-RoB30 31 52–58 and 6 were susceptible-to-some bias16 17 59–62 (online supplemental appendix 4). Common sources of bias included a lack of blinding, no allocation concealment, insufficient sample size or inappropriate reporting of sample size.…”

“…Ten studies evaluated work-related constructs following ACL injury 8 41 46 48 54 55 58 62 66 75. Six studies assessed total days of work absenteeism at least 2 years following ACL surgery.…”

“…At a mean 27 months after ACL injury, 2 (11%) individuals on work-compensation were unable to work due to their knee, 6 (32%) were working with knee limitations and symptoms and 2 (11%) had reduced their occupational work intensity (compared with 0 (0%), 2 (11%) and 1 (5%) participant(s) in the non-work cover group, respectively) 41. A study where 78% of ACL injured participants were employed in the military found that 13% had not returned to work 2 years after ACLR 62. Filbay et al (2017) reported a mean (SD) Workplace Activities Limitations Scale score of 4 (3) (scores range from 0 to 36 (higher score=greater impairment)) in 162 individuals with knee symptoms 5–20 years post-ACLR 8…”

Correlation of Isokinetic Testing and ACL Failure With the Short Graft Tape Suspension Technique at Six Months

“…Conserving the gracilis muscle would have a faster recovery time in flexion when compared to reconstruction requiring the removal of the two hamstrings. 19 , 20 , 21 , 22 Although isolated sampling of semitendinosus was performed, 36 , 37 isokinetic results on flexion at 6 months (60°/s) are still insufficient.…”

Post-Operative Results of ACL Reconstruction Techniques on Single-Leg Hop Tests in Athletes: Hamstring Autograft vs. Hamstring Grafts Fixed Using Adjustable Cortical Suspension in Both the Femur and Tibia

“…Anterior cruciate ligament (ACL) tears are common injuries in the athletic population, and accordingly, ACL reconstruction (ACLR) is among the most common orthopedic surgical procedures performed in sports medicine [ 1 , 2 , 3 ]. Today, the quadriceps tendon, patellar tendon, and semitendinosus/gracilis (ST/G) tendons are the most commonly used graft types in ACLR [ 4 ].…”