Relationship of Musculotendinous Junction Location to Harvested Semitendinosus and Gracilis Tendon Length

Ilahi, Omer A.; Stautberg, Eugene; Mansfield, David J.; Qadeer, Ali A.

doi:10.1177/2325967117704630

Cited by 4 publications

(2 citation statements)

References 19 publications

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“…They previously identified that a gross "tendon only length" >9.5 cm for the semitendinosus (ST) or 9 cm for gracilis (G) would be at very low risk of being too short in total tendon length for a robust ACL reconstruction. 6 The 95% confidence interval of the current study is quite large (3 cm) because of the high variability in the obtained lengths (9-17 and 9-15 cm for the ST and G, respectively). Therefore, the authors suggest a preoperative tendon-only length MRI measurement of >12.5 cm for the ST and 12 for the G to be confident that the total harvested tendon would not be <15 cm.…”

Section: See Related Article On Page 2457mentioning

confidence: 53%

Editorial Commentary: Goldilocks and the Three Grafts: Managing Tendon Harvest and Graft Length Problems in Autograft Anterior Cruciate Ligament Reconstruction

Gilmer¹

2018

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Autograft hamstring tendon harvest in anterior cruciate ligament (ACL) reconstruction can occasionally result in a graft length that is inadequate for creation of a robust ACL graft. Patients at risk for an abnormally short hamstring may also be high risk for ACL reinjury. Graft augmentation with allograft may be a suboptimal solution to this problem. Therefore, a reliable means for preoperative estimation of hamstring tendon length by magnetic resonance imaging measurement could avoid this pitfall. However, even with a reliable correlation between magnetic resonance imaging measurement and actual harvested tendon length, establishing a simple, clinically relevant threshold below which hamstring grafts should be avoided remains elusive. By contrast, all-soft-tissue quadriceps autograft avoids the potential length problems inherent to both bone tendon bone (graft-tunnel mismatch) and hamstring tendon grafts, but intermediate- and long-term outcome studies are still needed to validate all-soft-tissue quadriceps autograft in ACL reconstruction.

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Section: See Related Article On Page 2457mentioning

confidence: 53%

Editorial Commentary: Goldilocks and the Three Grafts: Managing Tendon Harvest and Graft Length Problems in Autograft Anterior Cruciate Ligament Reconstruction

Gilmer¹

2018

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Furthermore, a minimum length of 240 mm of semitendinosus and 160 mm of the gracilis tendon is required to prepare the 5S configuration. 17 Ilahi et al 15 noted that abnormally distal musculotendinous junctions of hamstring tendons can cause shorter grafts in the absence of technical error and affect the ability to employ a particular graft preparation technique, thus increasing uncertainty of graft utilization. Our study showed a preponderance of female patients and those of shorter stature and with lower weight undergoing the 5S graft configuration.…”

Section: Discussionmentioning

confidence: 99%

Performance of 5-Strand Hamstring Autograft Anterior Cruciate Ligament Reconstruction in the STABILITY Study: A Subgroup Analysis

et al. 2022

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Background: Anterior cruciate ligament (ACL) reconstructions (ACLRs) with graft diameters <8mm have been shown to have higher revision rates. The 5-strand (5S) hamstring autograft configuration is a proposed option to increase graft diameter. Purpose: To investigate the differences in clinical outcomes between 4-strand (4S) and 5S hamstring autografts for ACLR in patients who underwent ACLR alone or concomitantly with a lateral extra-articular tenodesis (LET) procedure. Study Design: Cohort study; Level of evidence, 2. Methods: Data from the STABILITY study were analyzed to compare a subgroup of patients undergoing ACLR alone or with a concomitant LET procedure (ACLR + LET) with a minimum graft diameter of 8mm that had either a 4S or 5S hamstring autograft configuration. The primary outcome was clinical failure, a composite of rotatory laxity and/or graft failure. The secondary outcome measures consisted of 2 patient-reported outcome scores (PROs)—namely, the ACL Quality of Life Questionnaire (ACL-QoL) and the International Knee Documentation Committee (IKDC) score at 24 months postoperatively. Results: Of the 618 patients randomized in the STABILITY study, 399 (228 male; 57%) fit the inclusion criteria for this study. Of these, 191 and 208 patients underwent 4S and 5S configurations of hamstring ACLR, respectively, with a minimum graft diameter of 8mm. Both groups had similar characteristics other than differences in anthropometric factors—namely, sex, height, and weight, and Beighton scores. The primary outcomes revealed no difference between the 2 groups in rotatory stability (odds ratio [OR], 1.19; 95% CI, 0.77-1.84; P = .42) or graft failure (OR, 1.13; 95% CI, 0.51-2.50; P = .76). There was no significant difference between the groups in Lachman ( P = .46) and pivot-shift ( P = .53) test results at 24 months postoperatively. The secondary outcomes revealed no differences in the ACL-QoL ( P = .67) and IKDC ( P = .83) scores between the 2 subgroups. Conclusion: At the 24-month follow-up, there were no significant differences in clinical failure rates and PROs in an analysis of patients with 4S and 5S hamstring autografts of ≥8mm diameter for ACLR or ACLR + LET. The 5S hamstring graft configuration is a viable option to produce larger-diameter ACL grafts.

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Optimization of surgical exposure for harvesting gracilis-semitendinosus tendons

Luo

Wang

et al. 2022

International Orthopaedics (SICOT)

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Relationship of Musculotendinous Junction Location to Harvested Semitendinosus and Gracilis Tendon Length

Cited by 4 publications

References 19 publications

Editorial Commentary: Goldilocks and the Three Grafts: Managing Tendon Harvest and Graft Length Problems in Autograft Anterior Cruciate Ligament Reconstruction

Editorial Commentary: Goldilocks and the Three Grafts: Managing Tendon Harvest and Graft Length Problems in Autograft Anterior Cruciate Ligament Reconstruction

Performance of 5-Strand Hamstring Autograft Anterior Cruciate Ligament Reconstruction in the STABILITY Study: A Subgroup Analysis

Optimization of surgical exposure for harvesting gracilis-semitendinosus tendons

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