Reconstruction of anterior cruciate ligament using a large-diameter autograft of 8-strand semitendinosus/gracilis
10.3760/cma.j.cn115530-20250304-00102
- VernacularTitle:8股半腱肌/股薄肌自体移植物重建前交叉韧带的疗效分析
- Author:
Hui ZHANG
1
;
Guanyang SONG
1
;
Yue LI
1
;
Tong ZHENG
1
;
Xuesong WANG
1
;
Daofeng WANG
1
Author Information
1. 首都医科大学附属北京积水潭医院运动医学科，北京市创伤骨科研究所，北京 100035
- Publication Type:Journal Article
- Keywords:
Knee joint;
Anterior cruciate ligament;
Transplants;
Tibial anterior translation;
Semitendinosus/gracilis
- From:
Chinese Journal of Orthopaedic Trauma
2025;27(5):388-394
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical outcomes of a large-diameter autograft of 8-strand semitendinosus/gracilis (8S-ST/G) in reconstruction of anterior cruciate ligament (ACL).Methods:A retrospective analysis was conducted of the 56 patients with primary ACL injury who had been treated by the 8S-ST/G autograft technique at Sports Medicine Service, Beijing Jishuitan Hospital, Capital Medical University between January 2019 and January 2022. The cohort included 42 males and 14 females, with an age of (28.3±7.3) years and a body mass index of (24.4±3.3) kg/m 2. There were 28 left and 28 right knees involved. The preoperative posterior tibial slope measured 14.8°±2.8°. The diameter of 8S-ST/G autograft was (9.3±0.7) mm. The postoperative outcomes documented were knee stability (assessed via KT-1000 arthrometer side-to-side difference, Lachman test, and pivot-shift test), graft maturity, graft roof impingement, and complications. Results:The patients were followed up for (2.4±0.3) years postoperatively. The side-to-side difference decreased significantly from preoperative 6.0 (5.0, 8.0) mm to postoperative 2.0 (0.0, 3.0) mm ( P<0.001). The positive rate of high-grade pivot shift (2+, 3+) reduced significantly from 50.0% (28/56) preoperatively to 3.6% (2/56) postoperatively ( P<0.001). The ACL graft signal grades revealed by the MRI at the final follow-up were grade Ⅰ in 45 cases, grade Ⅱ in 7 cases, and grade Ⅲ in 4 cases. After the 15 patients with their preoperative MRI from other hospitals (showing ACL graft signal of grade I in all) were excluded, the anterior subluxation of lateral compartment (ASLC) and anterior subluxation of medial compartment (ASMC) in the other 41 patients at the final follow-up [(4.8±3.1) mm and 3.0 (2.0, 4.9) mm, respectively] showed no significant differences from the preoperative values [(5.9±3.2) mm and 3.9 (0.0, 6.3) mm, respectively] ( P>0.05). However, in the 30 patients with well-preserved ACL graft signal (grade I), both ASLC and ASMC at the final follow-up [(3.9±2.5) mm and 3.0 (1.5, 4.7) mm] showed significant improvements compared to the preoperative values [(5.5±3.1) mm and 5.1 (2.7, 6.2) mm] ( P<0.05). At the final follow-up, 19.6% (11/56) of the patients showed ACL graft laxity; graft failure occurred in 8.9% (5/56) of the patients, one of whom underwent revision surgery. Second-look arthroscopy revealed concomitant cartilage injuries in 12.5% (7/56) of the patients, cyclops lesions in 3.6% (2/56), and ACL graft impingement in 7.1% (4/56). Conclusion:In the treatment of patients with ACL injury, the 8S-ST/G autograft configuration can significantly improve the stability of the knee joint and graft maturity, but it can not effectively correct the ASLC and ASMC for a subset of patients.
