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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-05-2017 | Knee

The natural history of donor hamstrings unit after anterior cruciate ligament reconstruction: a prospective MRI scan assessment

Authors: Ioannis Tsifountoudis, Ilias Bisbinas, Ioannis Kalaitzoglou, George Markopoulos, Aphrodite Haritandi, Athanasios Dimitriadis, Stergios Papastergiou

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2017

Abstract

Purpose

The aim of this prospective study was to assess the natural history of the donor hamstrings, compared to the contralateral knee and thigh.

Methods

In 47 patients who had ACL reconstruction (hamstrings technique), bilateral knees and thighs were investigated using MRI scans, up to 2 years post-operatively.

Results

Tendon regeneration below the knee joint line of the semitendinosus occurred in 30/47 (64 %) patients and of the gracilis tendon in 17/47 (36 %) patients. Insertion of both tendons at the “pes anserinus”, with normal anatomic relations, was observed in 5/47 (11 %) patients. Semitendinosus and gracilis donor muscles were found retracted in 41/47 (87 %) patients. In 25/47 (53 %) patients, there was evidence of fatty infiltration of the semitendinosus muscle. All (47/47) (100 %) patients showed semitendinosus muscle atrophy and 41/47 (87 %) patients showed gracilis muscle atrophy, compared to the contralateral limb. High signal intensity on STIR images was observed in the semitendinosus in 22/47 (46 %) patients and in the gracilis muscle in 30/47 (64 %) patients, on MRI examination performed up to 24 months post-operatively.

Conclusions

The “regenerated” hamstrings tendons most commonly do not regenerate fully anatomically, so they should not be considered as a first choice for re-harvesting in revision ACL reconstruction. The “donor hamstrings muscles” are found to be shorter, contracted, thinner and with a long-term abnormal MRI signal, features which are considered to be related to reduced muscle performance (knee flexion and internal rotation) post-operatively.

Level of evidence

II.

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Title: The natural history of donor hamstrings unit after anterior cruciate ligament reconstruction: a prospective MRI scan assessment
Authors: Ioannis Tsifountoudis
Ilias Bisbinas
Ioannis Kalaitzoglou
George Markopoulos
Aphrodite Haritandi
Athanasios Dimitriadis
Stergios Papastergiou
Publication date: 01-05-2017
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 5/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-015-3732-3

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Springer Medicine

The natural history of donor hamstrings unit after anterior cruciate ligament reconstruction: a prospective MRI scan assessment

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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