Evaluation of regeneration of semitendinosus tendon using ultrasound imaging and isokinetic strength testing after graft harvest for arthroscopic anterior cruciate ligament reconstruction

Perumal, Suresh; Thiyagarajan, K.A.; Prakash, Ayyadurai; Sabareeswaran, A

doi:10.1016/j.jor.2020.07.002

Cited by 4 publications

(2 citation statements)

References 17 publications

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“…The observed retractions correspond well with recent observations by Messer et al that found an average side-to-side length diference of 70 mm [6,11]. Larger retraction has been reported in patients with no tendon regeneration [1,5,7,8] which is reported in 40-60% of operated patients [5,9]. Tendon regeneration was not an aim of this study and is as such not examined.…”

Section: Discussionsupporting

confidence: 91%

Anatomical retraction of the semitendinosus muscle following harvest of the distal semitendinosus tendon for ACL reconstruction

Speedtsberg

Zebis

Lauridsen

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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Purpose Retraction of semitendinosus muscle has been reported after reconstruction of the anterior cruciate ligament with semitendinosus/gracilis-graft. However, very little data exist on the natural variation in side-to-side length symmetry. The purpose of this study was to investigate the side-to-side asymmetry of semitendinosus muscle length in individuals with ACL reconstruction (ACLR) using the semitendinosus/gracilis-graft compared to a group of healthy control subjects to establish the level of retraction that can conidently be ascribed the surgery. Methods Eleven subjects aged 30 (19-39) years, with previous unilateral ACLR with the combined semitendinosus/gracilis tendon graft were recruited. Average follow-up was 6.8 years (0.3-13.0) after reconstruction. Ten healthy subjects aged 30 years (23-36) with no previous knee surgery served as controls. Bilateral magnetic resonance imaging (MRI) scans were obtained of the thigh from 60 mm below the knee joint and 700 mm proximal to this point with a slice thickness of 5 mm with 5 mm inter-slice distance. Semitendinosus length was measured on both legs between the distal and proximal musculotendinous junction of the semitendinosus. Length diference between legs was calculated for all participants. Percentage of shortening was expressed relative to the healthy leg. Results Subjects who had undergone ACLR had on average 81 mm (25%) shortening of the semitendinosus on the reconstructed leg compared to the non-reconstructed side. The healthy subjects all had less than 10 mm diference between legs (< 3%). The side-to-side diference was signiicantly diferent between the reconstructed patients and the healthy subjects (p < 0.001). Conclusion This study indicates that retraction larger than 10 mm is a consequence of the tendon harvest and not natural variation. It also supports that persistent retraction of the semitendinosus muscle occurs following harvest of the semitendinosus tendon for ACL graft. Level of evidence Level IV.

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Section: Discussionsupporting

confidence: 91%

Anatomical retraction of the semitendinosus muscle following harvest of the distal semitendinosus tendon for ACL reconstruction

Speedtsberg

Zebis

Lauridsen

et al. 2021

Knee Surg Sports Traumatol Arthrosc

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show abstract

“…At 4 months post-surgery, the H-LSI is related to the recovery of hamstring strength [ 39 ]. This recovery can sometimes be late due to posterior knee pain or arthrofibrosis and is rarely complete at 12 months post-surgery (H-LSI: 83 to 95%) due to the regeneration of the hamstring tendons [ 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

Relevant Strength Parameters to Allow Return to Running after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autograft

Grondin

Crenn

Gernigon

et al. 2022

IJERPH

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After anterior cruciate ligament reconstruction (ACLR), a progressive process is followed from rehabilitation to the return to sport including a crucial step known as the return to running. Return to running (RTR) can be predicted by an isokinetic knee strength assessment at 4 months post-surgery. All patients who had primarily undergone ACLR with a hamstring autograft procedure between 2010 and 2020 were included in this study. Four months after surgery, patients were evaluated using an isokinetic knee strength test. Patients were monitored until the 6th month post-surgery to see if they had returned to running. Comparisons were carried out between the two groups—the RTR and the no-RTR. A multivariate logistic regression analysis was used to predict the RTR status from explicative parameters. Receiver Operating Characteristic (ROC) curves were established to identify cutoffs with their characteristics. A total of 413 patients were included and 63.2% returned to running at 4 months post-surgery. The mean Lysholm score, knee complication rate, and isokinetic parameters were statistically different between both groups. Using a multivariate logistic regression model and ROC curves, the best isokinetic parameter to assist with the decision to allow an RTR was the quadriceps limb symmetry index at 60°/s with a cutoff of 65%. The hamstring LSI at 180°/s could be added (cutoff of 80%) to slightly increase the prediction of an RTR. Quadriceps strength normalized to body weight at 60°/s is a useful parameter (cutoff: 1.60 Nm/kg) but measurements on both sides are necessary. Isokinetic parameters are objective parameters to allow a return to running at 4 months after ACLR with a hamstring procedure.

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Characterizing focal muscle signal on MRI in flexor-pronator muscles’ status post ulnar collateral ligament reconstruction

et al. 2023

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Evaluation of regeneration of semitendinosus tendon using ultrasound imaging and isokinetic strength testing after graft harvest for arthroscopic anterior cruciate ligament reconstruction

Cited by 4 publications

References 17 publications

Anatomical retraction of the semitendinosus muscle following harvest of the distal semitendinosus tendon for ACL reconstruction

Anatomical retraction of the semitendinosus muscle following harvest of the distal semitendinosus tendon for ACL reconstruction

Relevant Strength Parameters to Allow Return to Running after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autograft

Characterizing focal muscle signal on MRI in flexor-pronator muscles’ status post ulnar collateral ligament reconstruction

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