Functional Effects of Single Semitendinosus Tendon Harvesting in Anatomic Anterior Cruciate Ligament Reconstruction: Comparison of Single versus Dual Hamstring Harvesting
10.4055/cios.2019.11.1.60
- Author:
Dhong Won LEE
1
;
Jae Chan SHIM
;
Sang Jin YANG
;
Seung Ik CHO
;
Jin Goo KIM
Author Information
1. Department of Orthopaedic Surgery, Konkuk University Medical Center, Seoul, Korea. boram107@hanmail.net
- Publication Type:Original Article
- Keywords:
Anterior cruciate ligament;
Hamstring regeneration;
Knee flexor strength;
Hamstring strength;
Serial ultrasonography
- MeSH:
Anterior Cruciate Ligament Reconstruction;
Anterior Cruciate Ligament;
Arthroscopy;
Follow-Up Studies;
Joints;
Knee;
Lysholm Knee Score;
Magnetic Resonance Imaging;
Regeneration;
Tendons;
Transplants;
Ultrasonography
- From:Clinics in Orthopedic Surgery
2019;11(1):60-72
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: This study aimed to determine the effects of single semitendinosus tendon (ST) harvesting for anterior cruciate ligament (ACL) reconstruction by comparing outcomes of single ST and semitendinosus-gracilis tendon (ST-G) harvesting. METHODS: ACL reconstruction with ST-G harvesting (D group, n = 60) or single ST harvesting (S group, n = 60) were included according to inclusion criteria. Subjective assessments included subjective International Knee Documentation Committee score, Lysholm score, and Tegner activity scale score. Objective assessments included isokinetic strength and functional tests. These tests were completed at 36 months of follow-up. Magnetic resonance imaging (MRI) and second-look arthroscopy findings were evaluated. In the S group, regeneration properties were assessed by serial ultrasonography (US). RESULTS: The S group showed significantly less deep flexor strength deficit than the D group (p < 0.001). Deep flexor power deficits showed significant correlation with the shift of musculotendinous junction of the ST. There was significant difference in the cocontraction test between the groups (p = 0.012), and the S group tended to show better results in other functional tests at the last follow-up. There were no significant differences in graft tension and synovial coverage on second-look arthroscopy between the groups. In the S group, the regeneration rates assessed by US at the joint line and distal insertion were 81.7% and 80%, respectively at 6 months of follow-up. CONCLUSIONS: The S group showed significantly less deficit in deep flexor strength and tended to show better clinical results at the last follow-up than the D group. In the S group, more than 80% showed good regeneration at the 6-month follow-up. Hence, single ST harvesting is effective in minimizing flexor weakness and functional deficits and shows great potential for regeneration.
