ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #732

 

A Randomized Controlled Study of ACL Reconstruction with Semitendinosus or Semitendinosus and Gracilis Autograft: Functional Assessment Nine Months After Surgery

Anne Gro Heyn Faleide, MSc, Bergen NORWAY
Thomas Harlem, MD, Bergen NORWAY
Søren Vindfeld, MD, Bergen NORWAY
Bård E. Bogen, MSc, Bergen NORWAY
Torbjørn Strand, MD, Bergen NORWAY
Eivind Inderhaug, MD, PhD, MPH, Boenes NORWAY

Haraldsplass Deaconess Hospital, Bergen, NORWAY

FDA Status Not Applicable

Summary

Preliminary functional results of a randomized controlled trial of ACL reconstruction with semitendinosus or semitendinosus and gracilis autograft.

Abstract

Introduction

The main goal of Anterior Cruciate Ligament reconstruction is to restore knee stability to enable return to the desired level of activity. When using a hamstring autograft, the most common technique is to harvest both the semitendinosus and gracilis tendon. Less commonly only the semitendinosus is used. There is paucity in the literature on whether this alternative method leads to less loss of muscle strength and function – and hence, accelerated rehabilitation and return to sport.

Method

One hundred and eight patients undergoing primary reconstruction of the anterior cruciate ligament are included in an ongoing prospective randomized trial where two techniques using hamstring graft are compared. Preliminary results are presented. Single legged hop tests (4 tests: 1 and 3 hop cm, 3 cross hops cm and 6 m timed hop sec) and isokinetic measurement of strength (peak torque) are performed before and after surgery. The results are presented as a percentage difference between the limbs (Leg Symmetry Index, LSI%). Independent samples T-test was performed to examine potential differences between the groups preoperative and 9 months after surgery.

Results

Sixty-nine patients, 40 men (58%), mean age 33.7 (SD ± 10.1, Range 17-53) were included in the analyses. Before surgery, 35 (51%) patients completed the hop tests and 53 (77%) completed the strength testing. LSIsumscore for the hop tests was 88% (SD ± 10.3) in the semitendinosus only group and 85% (SD ± 10.8) in the standard group. LSI for strength in flexion was respectively 81% (SD ± 17.7) and 80% (SD ± 22.7). There were no significant differences between the two groups before surgery. Nine months after surgery, 55 (80%) of the patients completed the tests. LSIsumscore for the hop tests was 91% in both groups (SD ± 7.4 and ± 12.1 in the semitendinosus only and standard group, respectively). LSI for strength in flexion was 83% (SD ± 15.7) and 82% (SD ± 18.2) in the semitendinosus only group and standard group respectively. There were no significant differences in function between the two groups nine months after surgery.

Conclusion

Preliminary analysis of 69 participants nine months after surgery did not reveal any difference in performance on functional tests in patients that underwent the gracilis sparing technique and patients who underwent the standard hamstring technique. This may indicate that patients who only have their semitendinosus harvested have equal, but not better function nine months after surgery.
Final analysis and conclusion cannot be drawn until the trial is finished. Even though no differences were found between the groups, peak torque may have limitations when it comes to measuring strength and function of the semitendinosus and gracilis combined.