Top

Journal of Orthopaedic Science

Published in:

01-01-2012 | Original Article

Effects of knee immobilization on morphological changes in the semitendinosus muscle–tendon complex after hamstring harvesting for anterior cruciate ligament reconstruction: evaluation using three-dimensional computed tomography

Authors: Atsuo Nakamae, Masataka Deie, Nobuo Adachi, Tomoyuki Nakasa, Makoto Nishimori, Mitsuo Ochi

Published in: Journal of Orthopaedic Science | Issue 1/2012

Abstract

Background

It is desirable to maintain the morphology of the semitendinosus muscle–tendon complex after tendon harvesting for anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to evaluate the effect of knee immobilization on morphological changes in the semitendinosus muscle–tendon complex.

Methods

In total, 39 patients who underwent ACL reconstruction with autologous semitendinosus tendons were included in this study. After surgery, the knee was immobilized for 3 days in 1 group of patients (group 1; 24 patients; control group) and for a longer period (10–14 days) in the other group (group 2; 15 patients). Three-dimensional computed tomography (3D CT) examination was performed at 6 and/or 12 months after the surgery for all patients. Morphological changes in the semitendinosus muscle–tendon complex (proximal shift of the semitendinosus muscle–tendon junction, width of the regenerated semitendinosus tendons, re-insertion sites of the regenerated tendons, and rate of semitendinosus tendon regeneration) were evaluated.

Results

Successful regeneration of the semitendinosus tendon was confirmed in all patients in group 2. In group 1, 3D CT showed that regeneration of the semitendinosus tendon was unsuccessful in 1 of the 24 patients. The average length of the proximal shift of the semitendinosus muscle–tendon junction was 7.3 ± 2.5 cm in group 1 and 7.2 ± 1.9 cm in group 2. There were no significant differences between the 2 groups with regard to the morphological changes in the semitendinosus muscle–tendon complex.

Conclusions

This study showed that the structure of regenerated tendons could be clearly identified in 38 of 39 cases (97.4%) after ACL reconstruction. However, prolonged knee immobilization (10–14 days) could not prevent morphological changes in the semitendinosus muscle–tendon complex.

Cross MJ, Roger G, Kujawa P, Anderson IF. Regeneration of the semitendinosus and gracilis tendons following their transection for repair of the anterior cruciate ligament. Am J Sports Med. 1992;20:221–3.PubMedCrossRef

Eriksson K, Larsson H, Wredmark T, Hamberg P. Semitendinosus tendon regeneration after harvesting for ACL reconstruction. A prospective MRI study. Knee Surg Sports Traumatol Arthrosc. 1999;7:220–5.PubMedCrossRef

Hioki S, Fukubayashi T, Ikeda K, Niitsu M, Ochiai N. Effect of harvesting the hamstrings tendon for anterior cruciate ligament reconstruction on the morphology and movement of the hamstrings muscle: a novel MRI technique. Knee Surg Sports Traumatol Arthrosc. 2003;11:223–7.PubMedCrossRef

Makihara Y, Nishino A, Fukubayashi T, Kanamori A. Decrease of knee flexion torque in patients with ACL reconstruction: combined analysis of the architecture and function of the knee flexor muscles. Knee Surg Sports Traumatol Arthrosc. 2006;14:310–7.PubMedCrossRef

Nakamae A, Deie M, Yasumoto M, Adachi N, Kobayashi K, Yasunaga Y, Ochi M. Three-dimensional computed tomography imaging evidence of regeneration of the semitendinosus tendon harvested for anterior cruciate ligament reconstruction: a comparison with hamstring muscle strength. J Comput Assist Tomogr. 2005;29:241–5.PubMedCrossRef

Nakamura E, Mizuta H, Kadota M, Katahira K, Kudo S, Takagi K. Three-dimensional computed tomography evaluation of semitendinosus harvest after anterior cruciate ligament reconstruction. Arthroscopy. 2004;20:360–5.PubMedCrossRef

Nikolaou VS, Efstathopoulos N, Wredmark T. Hamstring tendons regeneration after ACL reconstruction: an overview. Knee Surg Sports Traumatol Arthrosc. 2007;15:153–60.PubMedCrossRef

Nishino A, Sanada A, Kanehisa H, Fukubayashi T. Knee-flexion torque and morphology of the semitendinosus after ACL reconstruction. Med Sci Sports Exerc. 2006;38:1895–900.PubMedCrossRef

Tadokoro K, Matsui N, Yagi M, Kuroda R, Kurosaka M, Yoshiya S. Evaluation of hamstring strength and tendon regrowth after harvesting for anterior cruciate ligament reconstruction. Am J Sports Med. 2004;32:1644–50.PubMedCrossRef

10.

Aune AK, Holm I, Risberg MA, Jensen HK, Steen H. Four-strand hamstring tendon autograft compared with patellar tendon-bone autograft for anterior cruciate ligament reconstruction. A randomized study with two-year follow-up. Am J Sports Med. 2001;29:722–8.PubMed

11.

Goradia VK, Grana WA. A comparison of outcomes at 2 to 6 years after acute and chronic anterior cruciate ligament reconstructions using hamstring tendon grafts. Arthroscopy. 2001;17:383–92.PubMedCrossRef

12.

Nakamura N, Horibe S, Sasaki S, Kitaguchi T, Tagami M, Mitsuoka T, Toritsuka Y, Hamada M, Shino K. Evaluation of active knee flexion and hamstring strength after anterior cruciate ligament reconstruction using hamstring tendons. Arthroscopy. 2002;18:598–602.PubMedCrossRef

13.

Ferretti A, Conteduca F, Morelli F, Masi V. Regeneration of the semitendinosus tendon after its use in anterior cruciate ligament reconstruction: a histologic study of three cases. Am J Sports Med. 2002;30:204–7.PubMed

14.

Papandrea P, Vulpiani MC, Ferretti A, Conteduca F. Regeneration of the semitendinosus tendon harvested for anterior cruciate ligament reconstruction. Evaluation using ultrasonography. Am J Sports Med. 2000;28:556–61.PubMed

15.

Carofino B, Fulkerson J. Medial hamstring tendon regeneration following harvest for anterior cruciate ligament reconstruction: fact, myth, and clinical implication. Arthroscopy. 2005;21:1257–65.PubMedCrossRef

16.

Ho JY, Gardiner A, Shah V, Steiner ME. Equal kinematics between central anatomic single-bundle and double-bundle anterior cruciate ligament reconstructions. Arthroscopy. 2009;25:464–72.PubMedCrossRef

17.

Kanaya A, Ochi M, Deie M, Adachi N, Nishimori M, Nakamae A. Intraoperative evaluation of anteroposterior and rotational stabilities in anterior cruciate ligament reconstruction: lower femoral tunnel placed single-bundle versus double-bundle reconstruction. Knee Surg Sports Traumatol Arthrosc. 2009;17:907–13.PubMedCrossRef

18.

Ochi M, Adachi N, Deie M, Kanaya A. Anterior cruciate ligament augmentation procedure with a 1-incision technique: anteromedial bundle or posterolateral bundle reconstruction. Arthroscopy. 2006;22:463.e1–5.

19.

Ochi M, Adachi N, Uchio Y, Deie M, Kumahashi N, Ishikawa M, Sera S. A minimum 2-year follow-up after selective anteromedial or posterolateral bundle anterior cruciate ligament reconstruction. Arthroscopy. 2009;25:117–22.PubMedCrossRef

20.

Sunagawa T, Ochi M, Ishida O, Ono C, Ikuta Y. Three-dimensional CT imaging of flexor tendon ruptures in the hand and wrist. J Comput Assist Tomogr. 2003;27:169–74.PubMedCrossRef

21.

Sunagawa T, Ishida O, Ishiburo M, Suzuki O, Yasunaga Y, Ochi M. Three-dimensional computed tomography imaging: its applicability in the evaluation of extensor tendons in the hand and wrist. J Comput Assist Tomogr. 2005;29:94–8.PubMedCrossRef

Title: Effects of knee immobilization on morphological changes in the semitendinosus muscle–tendon complex after hamstring harvesting for anterior cruciate ligament reconstruction: evaluation using three-dimensional computed tomography
Authors: Atsuo Nakamae
Masataka Deie
Nobuo Adachi
Tomoyuki Nakasa
Makoto Nishimori
Mitsuo Ochi
Publication date: 01-01-2012
Publisher: Springer Japan
Published in: Journal of Orthopaedic Science / Issue 1/2012
Print ISSN: 0949-2658
Electronic ISSN: 1436-2023
DOI: https://doi.org/10.1007/s00776-011-0163-y

At a glance: The STEP trials

Springer Medicine

Effects of knee immobilization on morphological changes in the semitendinosus muscle–tendon complex after hamstring harvesting for anterior cruciate ligament reconstruction: evaluation using three-dimensional computed tomography

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2012

Characteristics of neck and shoulder pain (called katakori in Japanese) among members of the nursing staff

Surgical site infection in malignant soft tissue tumors

Pelvic support osteotomy for unstable hips using hybrid external fixator: case series and review of literature

Percutaneously absorbed NSAIDs attenuate local production of proinflammatory cytokines and suppress the expression of c-Fos in the spinal cord of a rodent model of knee osteoarthritis

Arthroscopic gap distance can predict the degree of scapholunate ligament tears: a cadaver study

Pull-out suture in posterior root avulsion fracture of the medial meniscus: 2 cases