J Korean Orthop Assoc.  2015 Oct;50(5):387-393. 10.4055/jkoa.2015.50.5.387.

Mid-Term Results after Anterior Cruciate Ligament Reconstruction Using Four-Strand Single Semitendinosus Tendon

Affiliations
  • 1Department of Orthopaedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea. hskyung@knu.ac.kr

Abstract

PURPOSE
The purpose of this study was to evaluate the mid-term results after anterior cruciate ligament (ACL) reconstruction using a single four-strand semitendinosus tendon.
MATERIALS AND METHODS
We evaluated 81 patients (84 cases) who had undergone ACL reconstruction using an autologous single four-strand semitendinosus tendon. The patients consisted of 77 men and 4 women with a mean age of 28.8 years (15-59 years) years. Most injuries were sports related, and the largest number of cases occurred during a soccer game (38 cases). Combined injuries were meniscus injuries in 43 cases, cartilage injuries in 6 cases and medial collateral ligament injuries in 8 cases. Femoral fixation device was PINN-ACL CrossPin in 44 cases and extracortical suspension device in 40 cases. Suture tie around a screw post and an additional bioabsorbable screw were used for tibial fixation. The mean time from injury to surgery was 9+/-16 months (7 days-10 years) and the mean follow-up period was 72.0+/-8.3 months (53-95 months). Clinical evaluation was performed using Lachman test, pivot-shift test, KT-2000 arthrometer, Lysholm score, Tegner activity score, International Knee Documentation Committee (IKDC) score and return to pre-injury sports activity. Radiologic evaluation was performed using plain radiographs to evaluate joint space narrowing.
RESULTS
All patients showed normal range of motion at the final follow-up. The Lachman test was positive in 4 cases, and pivot-shift test was positive in 3 cases. Lysholm score improved from 76.7 to 92.2, Tegner activity score improved from 5.1 to 6, IKDC score improved from 72.0 to 86.5, and mean anterior translation by KT-2000 improved from 7.4 mm to 2.3 mm, and 80.2micro of patients returned to pre-injury sports activity. No significant differences in joint space narrowing were observed in plain radiographs.
CONCLUSION
In this study, good results were obtained after ACL reconstructions using the autologous four-strand single semitendinosus tendon with maintaining the joint stability at mid-term follow-up.

Keyword

anterior cruciate ligament reconstruction; semitendinosus tendon

MeSH Terms

Anterior Cruciate Ligament Reconstruction*
Anterior Cruciate Ligament*
Cartilage
Collateral Ligaments
Female
Follow-Up Studies
Humans
Joints
Knee
Male
Reference Values
Soccer
Sports
Sutures
Tendons*

Figure

  • Figure 1 (A) This figure shows the semitendinosus tendon harvesting technique with periosteum attachment. (B) Additional 2 cm periosteum was harvested.

  • Figure 2 (A) The semitendinosus tendon was harvested with 2 cm periosteum. (B) This figure shows the 4-strand semitendinosus tendon graft with suspension device.


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