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Peak torque angle of anterior cruciate ligament-reconstructed knee flexor muscles in patients with semitendinosus and gracilis autograft is shifted towards extension regardless of the postoperative duration of supervised physiotherapy

ABSTRACT: The study investigated whether the flexor muscles peak torque (PT) angle shifting towards extension observed in the involved knee in patients after anterior cruciate ligament reconstruction (ACLR) using semitendinosus and gracilis tendons (STGR) autograft is associated with the time of postoperative physiotherapy supervision.

SUBMITTER: Aleksandra Królikowska

PROVIDER: S-BSST222 | biostudies-other |

REPOSITORIES: biostudies-other

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Peak torque angle of anterior cruciate ligament-reconstructed knee flexor muscles in patients with semitendinosus and gracilis autograft is shifted towards extension regardless of the postoperative duration of supervised physiotherapy.

Project description:BACKGROUND:The observational cohort study investigated whether the flexor muscles peak torque (PT) angle shifting towards extension observed in the involved knee in patients after anterior cruciate ligament reconstruction (ACLR) using semitendinosus and gracilis tendon (STGR) autograft is associated with the postoperative physiotherapy supervision duration. METHODS:From 230 ACL-reconstructed males, we identified patients after ACLR utilizing STGR autograft and divided them into those who completed supervised physiotherapy <6 months (Group I; n = 77) and those who completed supervised physiotherapy ?6 months (Group II; n = 66). The mean follow-up time was 6.84 ± 1.47 months. The ACL-reconstructed patients were compared to 98 controls (Group III). Bilateral knee flexor muscle PT measurements were performed. The relative PT at 180°/s (RPT), PT angle at 180°/s, and range of motion at 180°/s were analysed. The RPT limb symmetry index (LSI) was calculated. Tests for dependent samples, one-way analysis of variance, post hoc test, and linear Pearson's correlation coefficient (r) calculations were performed. RESULTS:The shift towards extension was noted when comparing the ACL-reconstructed limb to the uninvolved limb (Group I, p ? 0.001; Group II, p ? 0.001) and to Group III (p ? 0.001), but it was not correlated with physiotherapy supervision duration (r = -0.037, p = 0.662). In ACL-reconstructed patients, there was a moderate association of supervision duration and knee flexor LSI (r = 0.587, p < 0.001). CONCLUSIONS:The ACL-reconstructed knee flexors PT angle shift towards extension was observed regardless of the duration of postoperative physiotherapy supervision. However, the analysis revealed that the duration of supervised physiotherapy positively influenced the RPT and LSI in patients after the ACLR.

| S-EPMC6363225 | biostudies-literature

Medial patellofemoral ligament reconstruction with semitendinosus autograft.

Project description:Patellar instability is a common complaint after traumatic dislocation of the patella. Traumatic dislocation always leads to tearing of the medial patellofemoral ligament (MPFL). Treatment consists of recovery from the traumatic injury, followed by reconditioning and physical therapy to strengthen the dynamic stabilizers of the patella. In patients with recurrent instability, detailed evaluation of the cause is required to determine the needed interventions. In patients with an incompetent MPFL and recurrent instability, reconstruction is indicated, along with other procedures to address other contributing factors. This article details our technique for MPFL reconstruction using semitendinosus autograft, which can be performed alone or in concert with other realignment procedures.

| S-EPMC3882702 | biostudies-literature

Arthroscopic labral reconstruction with gracilis autograft.

Project description:Despite growing interest in hip arthroscopy and labral preservation, some patients have severely damaged, degenerative, or deficient labrums and may be candidates for arthroscopic labral reconstruction. The ligamentum teres has been used as a graft source for open hip labral grafting, and the iliotibial band has been used in the arthroscopic setting. We present an alternative method of hip labral reconstruction using the gracilis autograft, which does not require post-harvest manipulation. Arthroscopic techniques for graft tensioning and labrum-graft overlap are introduced that may facilitate restoration of labral function in patients with otherwise non-salvageable labrums.

| S-EPMC3678657 | biostudies-literature

Patellar Tendon Repair With Ipsilateral Semitendinosus Autograft Augmentation.

Project description:Patellar tendon ruptures are rare but potentially devastating injuries. Acute repair after patellar tendon rupture affords the best opportunity for tension-free restoration of the extensor mechanism. Biological augmentation of primary repair is believed to decrease strain across the repair site and reduce the risk of rerupture. We present a technique for primary patellar tendon repair with bidirectional fixation using transosseous tunnels, suture anchor fixation, and ipsilateral hamstring autograft augmentation in a distal patellar pole socket.

| S-EPMC5765631 | biostudies-literature

Endoscopic Harvest of Autogenous Gracilis and Semitendinosus Tendons.

Project description:The hamstring autograft is one of the most popular grafts for anterior cruciate ligament (ACL) reconstruction. Although many techniques for arthroscopic ACL reconstruction using hamstring autografts have been invented, hamstring harvest techniques have not been focused. Hamstrings are harvested using an open technique that requires a 2- to 5-cm skin incision. In this Technical Note, we describe an endoscopic harvest technique of autogenous gracilis and semitendinosus tendon. This technique needs only a 1- to 1.5-cm skin incision and provides surgeons a sufficient view to safely harvest the hamstrings.

| S-EPMC6203230 | biostudies-literature

Combined All-Inside Anterior Cruciate Ligament Reconstruction and Minimally Invasive Posterolateral Corner Reconstruction Using Ipsilateral Semitendinosus and Gracilis Autograft.

Project description:The anterior cruciate ligament (ACL) is the most commonly injured knee ligament, particularly among adolescents and young adults. Unrecognized posterolateral laxity is understood as a major cause of ACL reconstruction failure, and concomitant injury to the posterolateral corner (PLC) is prevalent and underdetected. We advocate screening all ACL-deficient knees for PLC injury and present a technique combining minimally invasive PLC reconstruction with anatomic all-inside ACL reconstruction. The combined procedure uses only the ipsilateral hamstring tendons representing a major surgical advantage over traditional management approaches. The semitendinosus is quadrupled and attached to 2 adjustable suspensory cortical fixation devices to form the ACL graft. The gracilis tendon is looped through the fibula head and secured in a single femoral tunnel for the PLC reconstruction via 2 minimally invasive incisions. The use of a single femoral PLC tunnel combined with a single femoral ACL socket minimizes the risk of tunnel convergence.

| S-EPMC5442462 | biostudies-other

Anatomic Posterolateral Corner Reconstruction Using Semitendinosus and Gracilis Autografts: Surgical Technique.

Project description:An anatomically based posterolateral corner (PLC) reconstruction has emerged as a viable and clinically effective surgical technique for midsubstance ligamentous injuries in both the acute and chronic settings. There are several surgical techniques for PLC reconstruction; however, the classic anatomic reconstruction technique (LaPrade technique) is now considered the gold standard and was originally described using an Achilles tendon allograft. In this article, we describe a modified LaPrade autograft technique, in which the same tunnel position, graft passage, and fixation are used to reproduce the 3 primary stabilizers of the PLC. Instead of allografts, hamstring autografts are used while tunnel diameters and fixation devices are adapted to them. With the use of autograft tendons, difficulties related to graft length or asymmetry are encountered. We consider this technique a good alternative for an anatomically based PLC reconstruction, especially given the lower availability and higher cost of allograft tissues in several countries.

| S-EPMC7917225 | biostudies-literature

Anatomic Reinforced Medial Meniscal Root Reconstruction With Gracilis Autograft.

Project description:Meniscal root tears, left untreated, result in accelerated progression of arthritis. Numerous techniques to repair medial meniscus posterior root tears have been presented in the literature. Direct repair of the meniscus to bone without reconstructive tissue may result in a nonanatomic and biologically weak construct with a significant number of structural repair failures. Re-creation of the ligament-like structures that fix the meniscal root to bone is critical to restoring normal knee biomechanics. We present an arthroscopic reconstructive technique using gracilis autograft with suture reinforcement for medial meniscus posterior root tears.

| S-EPMC6470346 | biostudies-literature

The potential of using semitendinosus tendon as autograft in rabbit meniscus reconstruction.

Project description:Since transplantation of meniscal allograft or artificial menisci is limited by graft sources and a series of adverse events, substitution for meniscus reconstruction still needs to be explored. Natural biomaterials, which can provide a unique 3-D microenvironment, remain a promising alternative for tissue engineering. Among them, autograft is a preferred option for its safety and excellent biocompatibility. In this study, we utilized semitendinosus tendon autograft in meniscus reconstruction to investigate its fibrochondrogenic metaplasticity potential and chondroprotective effect. Tendon-derived stem cells (TDSCs) and synovial-derived mesenchymal stem cells (SMSCs), two most important stem cell sources in our strategy, exhibited excellent viability, distribution, proliferation and fibrochondrogenic differentiation ability in decellularized semitendinosus tendon (DST) scaffolds in vitro. Histologic evaluation of the tendon grafts in vivo suggested endogenous stem cells differentiated into fibrochondrocytes, synthesized proteoglycan, type II collagen and radial type I collagen at 12 weeks and 24 weeks post-surgery. As for elastic modulus and hardness of the grafts, there were no significant differences between native meniscus and regenerated meniscus at 24 weeks. The protection of condylar cartilage from degeneration was significantly better in the reconstruction group comparing to control group. Overall, semitendinosus tendon autograft seems to be a promising substitution in meniscus reconstruction.

| S-EPMC5539314 | biostudies-literature

Anatomic Acromioclavicular Ligament Reconstruction Using Semitendinosus Autograft With Suture Augmentation: Surgical Technique.

Project description:Acromioclavicular (AC) joint separations are common injuries and account for 3.2% of shoulder injuries. These injuries typically occur among adolescent and young adult athletes during contact sports, such as hockey, wrestling, and rugby. Low-grade AC joint separations (Rockwood grade I-II) are often successfully treated nonoperatively. High-grade AC joint separations (Rockwood grade IV-VI) have the potential to alter scapular kinematics, causing painful and restricted motion, and are often treated surgically. Over 150 surgical techniques have been described to treat AC joint separations. Techniques vary in the types of implants used (screws, pins), use of anatomic or nonanatomic reconstructions, number of drill holes used, use of arthroscopic or open procedures, use of distal clavicle resection, and types of augmentation (allografts, autografts, sutures). The procedure can be expensive, with the implants and grafts costing varied amounts and, at times, thousands of dollars. The purpose of this Technical Note is to describe an inexpensive method of open anatomic AC joint reconstruction using a single bone tunnel, suture tape, and a semitendinosus autograft.

| S-EPMC6624191 | biostudies-literature

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