Semitendinosus muscle in anterior cruciate ligament surgery

Eriksson, Karl; Hamberg, Per; Jansson, Eva; Larsson, H. Peter; Shalabi, Adel; Wredmark, Torsten

doi:10.1053/jars.2001.20961

Cited by 42 publications

(84 citation statements)

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“…If only the ST ST semitendinosus tendon was harvested with an intact G tendon, neotendon developed in 18 (72 %) cases, and then the insertion site was mostly below the joint line but above previous pes anserinus site, in 15 (83.3 %) of the legs. Our ultrasound findings are in agreement with findings from imaging studies in which the regenerated ST tendon seemed to insert more proximally on the gastrocnemius fascia rather than on the tibia, as does the native ST tendon [5,6,[17][18][19][20][21]. This different insertion pattern of the regenerated tendon could explain how it acts mainly as a flexor muscle rather than as a flexor and internal rotator [22][23][24].…”

Section: Discussionsupporting

confidence: 89%

“…One study evaluated the semitendinosus muscle by magnetic resonance imaging and biopsies from six to 12 months after isolated harvesting. It identified regenerated ST tendons with the insertion reported to be as a conjoined tendon together with the gracilis in nearly anatomical position at the pes anserinus [5,6]. Another study provides irrefutable structural evidence that the tendon regenerates with close-to-normal tissue [7].…”

Section: Introductionmentioning

confidence: 99%

“…In most cases, the ST tendon can regenerate after harvesting, showing similar morphology to the native tendon [5][6][7]. One study evaluated the semitendinosus muscle by magnetic resonance imaging and biopsies from six to 12 months after isolated harvesting.…”

Section: Introductionmentioning

confidence: 99%

“…Although some researchers have demonstrated a loss of hamstring muscle strength in such patients, most investigators have found only slight differences between the operated and the controlateral side in the postoperative period. Recovery of the muscle strength after division of the ST and G tendons can be explained by a process of functional regeneration of the tendons or by compensatory hypertrophy of other knee flexors [4,6,[8][9][10]. Morphological changes including atrophy and shortening of the ST have been confirmed in patients with ACL reconstruction using the ST tendon [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Semitendinosus tendon regeneration after anterior cruciate ligament reconstruction: can we use it twice?

Stevanovic

Blagojević

Petković

et al. 2013

International Orthopaedics (SICOT)

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Purpose It has been demonstrated that the semitendinosus tendon can regenerate after being harvested in its whole length and thickness for anterior cruciate ligament (ACL) reconstruction. Ultrasound studies and guided biopsies of the regenerated tendon have shown compatibility and resembling features of the normal tendon. The question is if this neo-tendon is biologically and functionally adequate for re-use? Methods Two randomised groups of 150 volunteers were followed up for two years after harvesting the semitendinosus only (25) or the semitendinosus and gracilis tendons (25) in ACL reconstruction. The patients were followed up with clinical and ultrasound examinations, biopsies and histological tests. Surgical exploration was done in three patients for macroscopic verification. The injected arteries of four lower limbs were dissected and the tendon's arterial supplies were examined. Results Seventy-two percent of the cases showed regeneration of the semitendinosus tendons. The neotendons were inserted mostly below the knee joint (83.3 %) where they had fused with the gracilis tendon, and above the joint (60 %) when the gracilis was harvested as well. The isokinetic strength of the hamstrings and quadriceps was not significantly diminished on the operated side. A macroscopic and histological analysis of the regenerated tendons demonstrates close resemblance to normal anatomy, with focal areas of fibrosis. In one patient the regenerated tendon was used for medial patellofemoral ligament reconstruction. Conclusion The semitendinosus muscle can recover and the tendon has great potential to regenerate after harvesting for ACL reconstruction. Our data suggest that the regenerated tendons could be used for iterative ligament reconstruction.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Semitendinosus tendon regeneration after anterior cruciate ligament reconstruction: can we use it twice?

Stevanovic

Blagojević

Petković

et al. 2013

International Orthopaedics (SICOT)

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“…nın kadavra dizlerinde anatomik çift demet, lateral olarak yerleştirilen anatomik tek demet ve anatomik olmayan yerleşimli tek demetle yaptıkları ÖÇBR da anatomik çift demetle yapılan rekonstrüksi-yon ile anatomik tek demetle yapılan ÖÇBR arasında ameliyat sonrası rotasyonel ve pivot şift laksitesi bakımından fark olmadığını ve her iki yöntemin anatomik olmayan tek demet ÖÇBR dan iyi olduğunu bildirmişlerdir [25]. [28]. Hastalarımızın her iki ekstremitenin fleksiyon ve ekstansiyondaki izokinetik kas güçle-ri farkını araştırmaya yönelik Cybex II dinamometresi ile yapılan ölçümlerinde ameliyat olan diz ile normal dizin en yüksek dön-dürme kuvvet değerleri bibirine oranlanmış, %80 ve üzeri sonuç-lar normal kabul edilmiş, hiçbir hastada %10'dan fazla güç kaybı saptanmamıştır.…”

Section: Introductionunclassified

Early Results of Anatomic Double Bundle Anterior Cruciate Ligament Reconstruction

Karakaplan¹,

Elmalı²,

Topgül³

et al. 2015

Ann Clin Anal Med

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ÖzetAmaç: Ön çapraz bağ (ÖÇB) rekonstrüksiyonunda amaç, normal anatomik yapıyı ve diz fonksiyonunu yeniden sağlamaktır. Geleneksel tek demet ÖÇB rekonstrüksiyonu (ÖÇBR) sonrası hastaların önemli bir kısmında instabilite şi-kayetleri devam etmektedir. Anatomik çift demet ÖÇBR, doğal anatomiye daha yakın olarak dizin normal kinematiklerini yeniden sağlıyabilir. Bu ça-lışmada çift demet ÖÇBR yaptığımız hastalarımızın erken dönem sonuçları-nı değerlendirmeyi amaçladık. Gereç ve Yöntem: Haziran 2009 ile Mart 2010 tarihleri arasında kliniğimizde otojen hamstring greftleri ile anatomik çift demet ÖÇBR yapılan 20 hasta, prospektif olarak Cincinnati, IKDC ve Lysholm skorları ile klinik olarak ve kas güçleri için Cybex II dinamometresi ile değer-lendirildiler. Bulgular: Ortalama takip süresi 17.8 ay (13-21 ay) dır. Hastaların Cincinnati, IKDC ve Lysholm skorları sırasıyla preop 18.1, 39.3 ve 39.8 iken post op 27.2, 76,3 ve 86.3 e yükselmiştir. Son kontrollerinde IKDC skorlarına göre hastaların 17 si (%85) A (mükemmel) ve B (iyi) grubunda 3'ü C (yeterli) grubunda yer aldı. Kuadriseps ve hamstring kas gruplarına ait güç ölçüm-lerinde hastaların ameliyat edilen dizleri ile sağlam dizleri arasında anlamlı fark bulunmadı. Tartışma: Hamstring tendonları ile femoral askı yöntemi kullanılarak yapılan çift demet ÖÇBR tatmin edici bir yöntemdir. Tekniğin klinik neticeyi iyileştirme, diz biyomekaniğini daha iyi restore etme ve dejenerasyonu önleme açısından yararlarını belirlemek için daha geniş sayıda, karşılaştır-malı ve uzun dönem çalışmalar gerekmektedir. Anahtar KelimelerÖn Çapraz Bağ; Diz; Rekonstrüksiyon; Çift Demet Abstract Aim: The goal in anterior cruciate ligament reconstruction (ACLR) is to restore the normal anatomic structure and function of the knee. In the significant proportion of patients after the traditional single-bundle ACLR, complaints of instability still continue. Anatomic double bundle ACLR may provide normal kinematics in knees, much closer to the natural anatomy. The aim of this study is to clinically assess the early outcomes of our anatomical double bundle ACLR. Material and Method: In our clinic between June 2009 and March 2010, performed the anatomic double bundle ACLR with autogenous hamstring grafts 20 patients were evaluated prospectively with Cincinnati, IKDC and Lysholm scores and in clinically for muscle strength and with Cybex II dynamometer. Results: The mean follow-up is 17.8 months (13-21 months). Patients' scores of Cincinnati, IKDC and Lysholm were respectively, preoperative 18.1, 39.3 and 39.8, while the post-op increased to 27.2, 76.3 and 86.3. In their last check, 17 percent of the patients according to IKDC scores (85%) A (excellent) and B (good) group and 3 patients took place as C (adequate) group. The power measurements of quadriceps and hamstring muscle groups of patients who underwent surgery showed no significant difference compared with the intact knees. Discussion: Double-bundle ACL reconstruction is a satisfactory method. There is a need comparative, long-term studies in large...

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Morphology of hamstring torque‐time curves following acl injury and reconstruction: mechanisms and implications

Bryant

Clark

Pua

2011

Journal Orthopaedic Research

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The purposes of this study were (i) to examine the effects of anterior cruciate ligament (ACL) status on hamstring force steadiness, peak hamstring strength, quadriceps (antagonist) activation, and physical performance, and (ii) to evaluate the associations of physical performance with hamstring steadiness and hamstring strength. Thirteen subjects with unilateral deficiency of the ACL (ACLD), 39 matched subjects with unilateral reconstructed ACL (ACLR; n ¼ 25 with bone-patella tendon-bone (ACLR-PT) graft and n ¼ 14 with combined semitendinosus and gracilis tendon (ACLR-STGT) graft) and 33 control subjects participated. Each subject performed maximaleffort isokinetic knee flexion repetitions at 1808 s À1 with electromyography (EMG) electrodes attached to their medial and lateral quadriceps muscles. Physical performance was assessed using the single-limb long hop for distance. Wavelet-derived mean instantaneous frequency (Mif) of flexor torque-time curves was significantly ( p < 0.05) higher (i.e., less smooth) in ACLR-STGT subjects compared to the ACLD, ACLR-PT and control subjects. No significant differences existed for peak hamstrings strength (i.e., peak torque produced) or quadriceps antagonist EMG activity. Positive correlations were identified between hamstrings force steadiness and quadriceps antagonist activity for ACLD (r ¼ 0.797), ACLR-PT (r ¼ 0.467), and ACLR-STGT (r ¼ 0.628) subjects. For ACLR-STGT subjects, reduced hamstrings force steadiness associated with poorer long-hop performance (r ¼ À0.695). Reduced steadiness amongst ACLR-STGT subjects may reflect motor output variability of the antagonist (i.e., quadriceps dyskinesia) and/or agonist musculature-a maladaptive feature which potentially contributes to poorer single-limb hop performance. Measures of hamstring force steadiness in combination with traditional measures of peak hamstring strength provide valuable clinical information regarding knee joint function following ACL injury/ACLR. ß

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Semitendinosus muscle in anterior cruciate ligament surgery

Cited by 42 publications

References 0 publications

Semitendinosus tendon regeneration after anterior cruciate ligament reconstruction: can we use it twice?

Semitendinosus tendon regeneration after anterior cruciate ligament reconstruction: can we use it twice?

Early Results of Anatomic Double Bundle Anterior Cruciate Ligament Reconstruction

Morphology of hamstring torque‐time curves following acl injury and reconstruction: mechanisms and implications

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