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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 9/2016

01-09-2016 | Knee

Evaluation of the semitendinosus tendon graft shift in the bone tunnel: an experimental study

Authors: Masataka Fujii, Yusuke Sasaki, Daisuke Araki, Takayuki Furumatsu, Shinichi Miyazawa, Toshifumi Ozaki, Monica Linde-Rosen, Patrick Smolinski, Freddie H. Fu

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 9/2016

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Abstract

Purpose

The purpose of this study was to measure the semitendinosus tendon graft shift at the tunnel aperture with graft bending using a simulated femoral bone tunnel.

Methods

Eight semitendinosus tendon grafts were used in this study. The median age of the specimen was 53 years (range 46–63). After stripping excess soft tissue, the semitendinosus tendon was doubled over the loop of the EndoButton CL (Smith and Nephew Inc.). The diameter of the graft was measured using a graft-sizing tube (Smith and Nephew Inc.) and verified to be 7.0 mm. A custom-made aluminium fixture, the size was 40.0 mm3, with 7.0-mm-diameter hole was used as a simulated femoral bone tunnel. The graft was inserted to the tunnel, and EndoButton was positioned to the outside of the tunnel on the fixture. The distal end of the graft was tensioned with 30 N at an angle of 15°, 30°, 45°, 60°, 75° that reproduced the graft bending angle during knee range of motion. The photograph of the tunnel aperture was taken at each graft bending angle using a digital camera, and the graft shift amount in the simulated tunnel was analysed using the computer software (ImageJ).

Results

The amount of the graft shift significantly increased when the graft bending angle was increased (P < 0.05). The biggest shift was observed when the graft bending angle was 75° in all specimens, and the value was 1.10 mm ± 0.12.

Conclusion

The present study suggests that even if the femoral tunnel was created in the centre of the ACL insertion site, the graft shifted within the tunnel in the direction of the tension applied to the graft during knee range of motion. Surgeons may have to consider the graft shift within the bone tunnel as well as the tunnel position in the restoration of the native ACL anatomy.
Literature
1.
Araki D, Kuroda R, Matsumoto T et al (2014) Three-dimensional analysis of bone tunnel changes after anatomic double-bundle anterior cruciate ligament reconstruction using multidetector-row computed tomography. Am J Sports Med 42(9):2234–2241CrossRefPubMed
2.
Arnoczky SP (1983) Anatomy of the anterior cruciate ligament. Clin Orthop Relat Res 172:19–25PubMed
3.
Bedi A, Maak T, Musahl V et al (2011) Effect of tunnel position and graft size in single-bundle anterior cruciate ligament reconstruction: an evaluation of time-zero knee stability. Arthroscopy 27:1543–1551CrossRefPubMed
4.
Brown CH Jr, Wilson DR, Hecker AT et al (2004) Graft-bone motion and tensile properties of hamstring and patellar tendon anterior cruciate ligament femoral graft fixation under cyclic loading. Arthroscopy 20:922–935CrossRefPubMed
5.
Ferretti M, Ekdahl M, Shen W et al (2007) Osseous landmarks of the femoral attachment of the anterior cruciate ligament: an anatomic study. Arthroscopy 23:1218–1225CrossRefPubMed
6.
Fuss FK (1991) Anatomy and function of the cruciate ligaments of the domestic pig (Sus scrofa domestica): a comparison with human cruciates. J Anat 178:11–20PubMedPubMedCentral
7.
Girgis FG, Marshall JL, Monajem A (1975) The cruciate ligaments of the knee joint: anatomical, functional and experimental analysis. Clin Orthop Relat Res 106:216–231CrossRefPubMed
8.
Harner CD, Baek GH, Vogrin TM et al (1999) Quantitative analysis of human cruciate ligament insertions. Arthroscopy 15:741–749CrossRefPubMed
9.
Iorio R, Vadala` A, Argento G et al (2007) Bone tunnel enlargement after ACL reconstruction using autologous hamstring tendons: a CT study. Int Orthop 31:49–55CrossRefPubMed
10.
Iriuchishima T, Tajima G, Shirakura K et al (2011) In vitro and in vivo AM and PL tunnel positioning in anatomical double bundle anterior cruciate ligament reconstruction. Arch Orthop Trauma Surg 131:1085–1090CrossRefPubMed
11.
Iwahashi T, Shino K, Nakata K et al (2008) Assessment of the “functional length” of the three bundles of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 16:167–174CrossRefPubMed
12.
Karlsson J, Irrgang JJ, van Eck CF et al (2011) Anatomic single- and double-bundle anterior cruciate ligament reconstruction. Part 2: clinical application of surgical technique. Am J Sports Med 39:2016–2026CrossRefPubMed
13.
Khalfayan EE, Sharkey PF, Alexander AH et al (1996) The relationship between tunnel placement and clinical results after anterior cruciate ligament reconstruction. Am J Sports Med 24:335–341CrossRefPubMed
14.
Kobayashi M, Nakagawa Y, Suzuki T et al (2006) A retrospective review of bone tunnel enlargement after anterior cruciate ligament reconstruction with hamstring tendons fixed with a metal round cannulated interference screw in the femur. Arthroscopy 22(10):1093–1099CrossRefPubMed
15.
Musahl V, Plakseychuk A, VanScyoc A et al (2005) Varying femoral tunnel between the anatomical footprint and isometric positions: effect on kinematics of the anterior cruciate ligament-reconstructed knee. Am J Sports Med 33(5):712–718CrossRefPubMed
16.
Natsu-ume T, Shino K, Nakata K et al (2001) Endoscopic reconstruction of the anterior cruciate ligament with quadrupled hamstring tendons. A correlation between MRI changes and restored stability of the knee. J Bone Joint Surg Br 83:834–837CrossRefPubMed
17.
Nishimoto K, Kuroda R, Mizuno K et al (2009) Analysis of the graft bending angle at the femoral tunnel aperture in anatomic double bundle anterior cruciate ligament reconstruction: a comparison of the transtibial and the far anteromedial portal technique. Knee Surg Sports Traumatol Arthrosc 17(3):270–276CrossRefPubMed
18.
Segawa H, Koga Y, Omori G et al (2003) Influence of the femoral tunnel location and angle on the contact pressure in the femoral tunnel in anterior cruciate ligament reconstruction. Am J Sports Med 31(3):444–448PubMed
19.
Steiner ME, Hecker AT, Brown CH Jr et al (1994) Anterior cruciate ligament graft fixation: comparison of hamstring and patellar tendon grafts. Am J Sports Med 22:240–247CrossRefPubMed
20.
Tachibana Y, Mae T, Shino K et al (2014) Morphological changes in femoral tunnels after anatomic anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-014-3252-6
21.
Takahashi M, Doi M, Abe M et al (2006) Anatomical study of the femoral and tibial insertions of the anteromedial and posterolateral bundles of human anterior cruciate ligament. Am J Sports Med 34(5):787–792CrossRefPubMed
22.
Webster KE, Feller JA, Hameister KA (2001) Bone tunnel enlargement following anterior cruciate ligament reconstruction: a randomized comparison of hamstring and patellar tendon grafts with 2-year follow-up. Knee Surg Sports Traumatol Arthrosc 9:86–91CrossRefPubMed
23.
Zantop T, Herbort M, Raschke MJ et al (2007) The role of the anteromedial and posterolateral bundles of the anterior cruciate ligament in anterior tibial translation and internal rotation. Am J Sports Med 35(2):223–227CrossRefPubMed
Metadata
Title
Evaluation of the semitendinosus tendon graft shift in the bone tunnel: an experimental study
Authors
Masataka Fujii
Yusuke Sasaki
Daisuke Araki
Takayuki Furumatsu
Shinichi Miyazawa
Toshifumi Ozaki
Monica Linde-Rosen
Patrick Smolinski
Freddie H. Fu
Publication date
01-09-2016
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 9/2016
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-014-3461-z

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