Differences in length and cross-section of semitendinosus and gracilis tendons and their effect on anterior cruciate ligament reconstruction

Abstract

The purpose of this anatomical study was to explore the morphological variations of the semitendinosus and gracilis tendons in length and cross-section and the statistical relationship between length, cross-section, and body height. We studied the legs of 93 humans in 136 cadavers. In 43 specimens (46.2%) it was possible to harvest the tendons from both legs. We found considerable differences in the length and cross-section of the semitendinosus and the gracilis tendons with a significant correlation between the two. A correlation between the length of the femur, reflecting height, and the length of the tendons was only observed in specimens harvested from women. The reason for this gender difference was unclear. Additionally, there was a correlation between the cross-sectional area of the tendons and the length of the femur. Surgeons should be aware of the possibility of encountering insufficient length of tendon when undertaking reconstructive surgery as a result of anatomical variations between patients.

Are pre-operative anthropometric parameters helpful in predicting length and thickness of quadrupled hamstring graft for ACL reconstruction in adults? A prospective study and literature review

“…The quadrupled hamstring autograft has gained popularity for the anterior cruciate ligament (ACL) reconstruction procedure due to fewer incidences of patello-femoral problems that are encountered in bone-patella tendon-bone grafts (BPTB) [1][2][3][4][5][6]. The quadrupled semitendinosus and gracilis tendon graft provides comparable stiffness and tensile properties in addition to better cosmesis and excellent clinical outcome when compared to BPTB [1][2][3][4][5][6].…”

“…The quadrupled semitendinosus and gracilis tendon graft provides comparable stiffness and tensile properties in addition to better cosmesis and excellent clinical outcome when compared to BPTB [1][2][3][4][5][6]. Although recent studies also show that there is no difference in functional outcomes and laxity when using either type of graft in female patients or when used for revision surgery, the choice of graft may depend on surgeon preference with hamstring graft being more popular among the two [7,8].…”

Architectural differences between the hamstring muscles

“…Since architecture affects significantly the force generation capacity of each muscle, studying hamstring muscle function in vivo often requires modeling of their architectural properties (Thelen et al, 2005;Chumanov et al, 2007). Such models are applied for the estimation of muscle and tendon length in subjects with cerebral palsy (Arnold et al, 2006), for the examination of hamstring injury potential in athletes (Thelen et al, 2005;Chumanov et al, 2007), for the improvement of ST tendon grafts for surgical reconstruction of anterior cruciate ligament (Pichler et al, 2008) or for the prediction of hamstring muscle forces based on electromyographic (EMG) signal recordings (Kellis and Katis, 2008a,b).…”

Muscle architecture variations along the human semitendinosus and biceps femoris (long head) length

“…Therefore, studying hamstring muscle function in vivo often requires modeling of their architectural properties (Thelen et al, 2005;Chumanov et al, 2007) such as tendon and muscle length, fascicle length (FL), pennation angle (PA) and muscle thickness (MT). Such models are applied for the estimation of muscle and tendon length in subjects with cerebral palsy (Arnold et al, 2006), for the examination of hamstring injury potential in athletes (Thelen et al, 2005;Chumanov et al, 2007), for the improvement of ST tendon grafts for surgical reconstruction of anterior cruciate ligament (Pichler et al, 2008) or for the prediction of hamstring muscle forces based on electromyographic signal recordings (Kellis and Katis, 2008).…”