ACL reconstruction using a quadruple semitendinosus graft with cortical fixations gives suitable isokinetic and clinical outcomes after 2 years
- 1 August 2020
- journal article
- research article
- Published by Wiley in Knee Surgery, Sports Traumatology, Arthroscopy
- Vol. 28 (8), 2468-2477
- https://doi.org/10.1007/s00167-020-06121-2
Abstract
Purpose The objective of this single-center randomized single-blinded trial was to assess the hypothesis that anterior cruciate ligament reconstruction (ACLR) using a four-strand semitendinosus (ST) graft with adjustable femoral and tibial cortical fixation produced good outcomes compared to an ST/gracilis (ST/G) graft with femoral pin transfixation and tibial bioscrew fixation. Follow-up was 2 years. Methods Patients older than 16 years who underwent primary isolated ACLR included for 1 year until August 2017 were eligible. The primary outcome measures were the subjective International Knee Documentation Committee (IKDC) score, isokinetic muscle strength recovery, and return to work within 2 years. The study was approved by the ethics committee. Results Of 66 eligible patients, 60 completed the study and were included, 33 in the 4ST group and 27 in the ST/G group. Mean age was 30.5 +/- 8.9 years in the 4ST group and 30.3 +/- 8.5 in the ST/G group (n.s.). No significant between-group differences were found for mean postoperative subjective IKDC (4ST group, 80.2 +/- 12.5; ST/G group, 83.6 +/- 13.6; n.s.), side-to-side percentage deficits in isokinetic hamstring strength (at 60 degrees/s: ST group, 17% +/- 16%; ST/G group, 14% +/- 11%; n.s.) or quadriceps strength (at 60 degrees/s: ST group, 14% +/- 12%; ST/G group, 19% +/- 17%; n.s.), return to work, pain during physical activities, side-to-side differential laxity, balance, loss of flexion/extension, or surgical complications. Conclusion This trial demonstrates that functional outcomes after 4ST for ACLR with cortical fixations could be as good, although not better, than those obtained using ST/G. The 4ST technique spares the gracilis tendon, which thus preserves the medial sided muscle and thereby could improve function and limit donor-side morbidity.This publication has 53 references indexed in Scilit:
- Bilateral and Unilateral Asymmetries of Isokinetic Strength and Flexibility in Male Young Professional Soccer PlayersJournal of Human Kinetics, 2013
- Factors Used to Determine Return to Unrestricted Sports Activities After Anterior Cruciate Ligament ReconstructionArthroscopy: The Journal of Arthroscopic & Related Surgery, 2011
- Guidelines for the Design and Conduct of Clinical Studies in Knee Articular Cartilage RepairCARTILAGE, 2011
- Quality of Life and Clinical Outcome After Anterior Cruciate Ligament Reconstruction Using Patellar Tendon Graft or Quadrupled Semitendinosus GraftThe American Journal of Sports Medicine, 2010
- Knee flexor strength recovery following hamstring tendon harvest for anterior cruciate ligament reconstruction: a systematic reviewOrthopedic Reviews, 2009
- Broken bioabsorbable femoral cross-pin as a cause of a chondral lesion after anterior cruciate ligament reconstructionBMJ Case Reports, 2009
- A Prospective Comparison of 3 Hamstring ACL Fixation Devices—Rigidfix, BioScrew, and Intrafix—Randomized into 4 Groups with 2 Years of Follow-UpThe American Journal of Sports Medicine, 2009
- Biomechanical Evaluation of Anterior Cruciate Ligament Femoral Fixation TechniquesThe American Journal of Sports Medicine, 2008
- A 10-Year Comparison of Anterior Cruciate Ligament Reconstructions with Hamstring Tendon and Patellar Tendon AutograftThe American Journal of Sports Medicine, 2007
- Repeatability of the KT-1000 arthrometer in a normal populationThe American Journal of Sports Medicine, 1990