Skip to main content
Top
Published in: BMC Musculoskeletal Disorders 1/2019

Open Access 01-12-2019 | AC Joint Separation | Research article

The gracilis tendon autograft is a safe choice for orthopedic reconstructive procedures: a consecutive case series studying the effects of tendon harvesting

Authors: Jonas S. Nordin, Ola Olsson, Karl Lunsjö

Published in: BMC Musculoskeletal Disorders | Issue 1/2019

Login to get access

Abstract

Background

The gracilis tendon is commonly used as an autograft to reconstruct torn tendons or ligaments in many parts of the body. Little is known about the subjective and functional outcome after gracilis tendon harvest. The aim of this study was to evaluate the outcome of the donor leg in patients undergoing such surgery.

Methods

Patients with chronic acromioclavicular joint dislocations undergoing coracoclavicular ligament reconstructions using autogenous gracilis tendon grafts were eligible for this study. The graft harvesting procedure was carried out in a standard fashion using a tendon stripper. Knee injury and Osteoarthritis Outcome Score (KOOS) were collected preoperatively and after 12 months. The first 5 patients were included retrospectively and lacked preoperative data, for these patients age- and gender matched normative KOOS scores were used as baseline values. Isometric knee flexor strength in 60° and 90° degrees of flexion was measured at final follow up at a median of 26 (14–56) months postoperatively with the non-operated leg used as reference.

Results

Twenty four patients were eligible for the study and 2 were excluded. The 22 patients available for analysis had a mean age of 44 (22–62) years at the time of surgery and 4 were women. There was no statistically significant change in KOOS 12 months postoperatively compared to baseline values but the patients were weaker in knee flexion in the operated leg compared to the non-operated one.

Conclusions

Gracilis tendon harvesting results in a weakness of knee flexion but does not impair subjective knee function and is a procedure that can be recommended when an autogenous tendon graft is needed.
Literature
1.
go back to reference Cody EA, Karnovsky SC, DeSandis B, Tychanski Papson A, Deland JT, Drakos MC. Hamstring autograft for foot and ankle applications. Foot Ankle Int. 2018;39(2):189–95.CrossRef Cody EA, Karnovsky SC, DeSandis B, Tychanski Papson A, Deland JT, Drakos MC. Hamstring autograft for foot and ankle applications. Foot Ankle Int. 2018;39(2):189–95.CrossRef
2.
go back to reference Karnovsky SC, Desandis B, Papson AK, O’Malley Q, DiGiacomo R, O’Malley MJ, Cabe TN, Drakos MC. Tibialis anterior reconstruction with hamstring autograft using a minimally invasive approach. Foot Ankle Int. 2018;39(5):535–41.CrossRef Karnovsky SC, Desandis B, Papson AK, O’Malley Q, DiGiacomo R, O’Malley MJ, Cabe TN, Drakos MC. Tibialis anterior reconstruction with hamstring autograft using a minimally invasive approach. Foot Ankle Int. 2018;39(5):535–41.CrossRef
3.
go back to reference Hagemeijer NC, Claessen FMAP, de Haan R, Riedijk R, Eygendaal DE, van den Bekerom MP. Graft site morbidity in elbow ligament reconstruction procedures: a systematic review. Am J Sports Med. 2017;45(14):3382–7.CrossRef Hagemeijer NC, Claessen FMAP, de Haan R, Riedijk R, Eygendaal DE, van den Bekerom MP. Graft site morbidity in elbow ligament reconstruction procedures: a systematic review. Am J Sports Med. 2017;45(14):3382–7.CrossRef
4.
go back to reference Schöttle P, Schmeling A, Romero J, Weiler A. Anatomical reconstruction of the medial patellofemoral ligament using a free gracilis autograft. Arch Orthop Trauma Surg. 2009;129(3):305–9.CrossRef Schöttle P, Schmeling A, Romero J, Weiler A. Anatomical reconstruction of the medial patellofemoral ligament using a free gracilis autograft. Arch Orthop Trauma Surg. 2009;129(3):305–9.CrossRef
5.
go back to reference Matsuda DK, Burchette RJ. Arthroscopic hip labral reconstruction with a Gracilis autograft versus labral Refixation:2-year minimum outcomes. Am J Sports Med. 2013;41(5):980–7.CrossRef Matsuda DK, Burchette RJ. Arthroscopic hip labral reconstruction with a Gracilis autograft versus labral Refixation:2-year minimum outcomes. Am J Sports Med. 2013;41(5):980–7.CrossRef
6.
go back to reference Moloney C, O'Sullivan K, O'Farrell D, Louw Q, Clifford AM. Hamstring muscle strength before and after anterior cruciate ligament reconstruction: a systematic review. Isokinet Exerc Sci. 2014;22(3):225–36.CrossRef Moloney C, O'Sullivan K, O'Farrell D, Louw Q, Clifford AM. Hamstring muscle strength before and after anterior cruciate ligament reconstruction: a systematic review. Isokinet Exerc Sci. 2014;22(3):225–36.CrossRef
7.
go back to reference Belk JW, Kraeutler MJ, Purcell JM, McCarty EC. Autograft versus allograft for posterior cruciate ligament reconstruction: an updated systematic review and meta-analysis. Am J Sports Med. 2018;46(7):1752–7.CrossRef Belk JW, Kraeutler MJ, Purcell JM, McCarty EC. Autograft versus allograft for posterior cruciate ligament reconstruction: an updated systematic review and meta-analysis. Am J Sports Med. 2018;46(7):1752–7.CrossRef
8.
go back to reference Tian S, Wang B, Liu L, Wang Y, Ha C, Li Q, Yang X, Sun K. Irradiated hamstring tendon allograft versus autograft for anatomic double-bundle anterior cruciate ligament reconstruction:midterm clinical outcomes. Am J Sports Med. 2016;44(10):2579–88.CrossRef Tian S, Wang B, Liu L, Wang Y, Ha C, Li Q, Yang X, Sun K. Irradiated hamstring tendon allograft versus autograft for anatomic double-bundle anterior cruciate ligament reconstruction:midterm clinical outcomes. Am J Sports Med. 2016;44(10):2579–88.CrossRef
9.
go back to reference Nordin JS, Aagaard KE, Lunsjö K. Chronic acromioclavicular joint dislocations treated by the GraftRope device: a prospective trial halted prematurely due to a high rate of complications. Acta Orthop. 2015;86(2):225–8.CrossRef Nordin JS, Aagaard KE, Lunsjö K. Chronic acromioclavicular joint dislocations treated by the GraftRope device: a prospective trial halted prematurely due to a high rate of complications. Acta Orthop. 2015;86(2):225–8.CrossRef
10.
go back to reference Hardy A, Casabianca L, Andrieu K, Baverel L, Noailles T. Complications following harvesting of patellar tendon or hamstring tendon grafts for anterior cruciate ligament reconstruction: systematic review of literature. Orthop Traumatol Surg Res. 2017;103(Suppl8):245–8.CrossRef Hardy A, Casabianca L, Andrieu K, Baverel L, Noailles T. Complications following harvesting of patellar tendon or hamstring tendon grafts for anterior cruciate ligament reconstruction: systematic review of literature. Orthop Traumatol Surg Res. 2017;103(Suppl8):245–8.CrossRef
11.
go back to reference Landes S, Nyland J, Elmlinger B, Tillett E, Caborn D. Knee flexor strength after ACL reconstruction: comparison between hamstring autograft, tibialis anterior allograft, and non-injured controls. Knee Surg Sports Traumatol Arthrosc. 2010;18(3):317–24.CrossRef Landes S, Nyland J, Elmlinger B, Tillett E, Caborn D. Knee flexor strength after ACL reconstruction: comparison between hamstring autograft, tibialis anterior allograft, and non-injured controls. Knee Surg Sports Traumatol Arthrosc. 2010;18(3):317–24.CrossRef
12.
go back to reference Yasuda K, Tsujino J, Ohkoshi Y, Tanabe Y, Kaneda K. Graft site morbidity with autogenous semitendinosus and gracilis tendons. Am J Sports Med. 1995;23(6):706–14.CrossRef Yasuda K, Tsujino J, Ohkoshi Y, Tanabe Y, Kaneda K. Graft site morbidity with autogenous semitendinosus and gracilis tendons. Am J Sports Med. 1995;23(6):706–14.CrossRef
13.
go back to reference McRae S, Leiter J, McCormack R, Old J, MacDonald P. Ipsilateral versus contralateral hamstring grafts in anterior cruciate ligament reconstruction: a prospective randomized trial. Am J Sports Med. 2013;41(11):2492–9.CrossRef McRae S, Leiter J, McCormack R, Old J, MacDonald P. Ipsilateral versus contralateral hamstring grafts in anterior cruciate ligament reconstruction: a prospective randomized trial. Am J Sports Med. 2013;41(11):2492–9.CrossRef
14.
go back to reference Carofino BC, Mazzocca AD. The anatomic coracoclavicular ligament reconstruction: surgical technique and indications. J Shoulder Elb Surg. 2010;19(Suppl2):37–46.CrossRef Carofino BC, Mazzocca AD. The anatomic coracoclavicular ligament reconstruction: surgical technique and indications. J Shoulder Elb Surg. 2010;19(Suppl2):37–46.CrossRef
15.
go back to reference Paradowski PT, Bergman S, Sunden-Lundius A, Lohmander LS, Roos EM. Knee complaints vary with age and gender in the adult population. Population-based reference data for the knee injury and osteoarthritis outcome score (KOOS). BMC Musculoskelet Disord. 2006;7:38.CrossRef Paradowski PT, Bergman S, Sunden-Lundius A, Lohmander LS, Roos EM. Knee complaints vary with age and gender in the adult population. Population-based reference data for the knee injury and osteoarthritis outcome score (KOOS). BMC Musculoskelet Disord. 2006;7:38.CrossRef
16.
go back to reference Lord JP, Aitkens SG, McCrory MA, Bernauer EM. Isometric and isokinetic measurement of hamstring and quadriceps strength. Arch Phys Med Rehabil. 1992;73(4):324–30.CrossRef Lord JP, Aitkens SG, McCrory MA, Bernauer EM. Isometric and isokinetic measurement of hamstring and quadriceps strength. Arch Phys Med Rehabil. 1992;73(4):324–30.CrossRef
17.
go back to reference Hughes G, Watkins J. A risk-factor model for anterior cruciate ligament injury. Sports Med. 2006;36(5):411–28.CrossRef Hughes G, Watkins J. A risk-factor model for anterior cruciate ligament injury. Sports Med. 2006;36(5):411–28.CrossRef
18.
go back to reference Lee JWY, Mok KM, Chan HCK, Yung PSH, Chan KM. Eccentric hamstring strength deficit and poor hamstring-to-quadriceps ratio are risk factors for hamstring strain injury in football: a prospective study of 146 professional players. J Sci Med Sport. 2018;21(8):789–93.CrossRef Lee JWY, Mok KM, Chan HCK, Yung PSH, Chan KM. Eccentric hamstring strength deficit and poor hamstring-to-quadriceps ratio are risk factors for hamstring strain injury in football: a prospective study of 146 professional players. J Sci Med Sport. 2018;21(8):789–93.CrossRef
19.
go back to reference Roos EM, Lohmander LS. The knee injury and osteoarthritis outcome score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes. 2003;1(1):1–8.CrossRef Roos EM, Lohmander LS. The knee injury and osteoarthritis outcome score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes. 2003;1(1):1–8.CrossRef
Metadata
Title
The gracilis tendon autograft is a safe choice for orthopedic reconstructive procedures: a consecutive case series studying the effects of tendon harvesting
Authors
Jonas S. Nordin
Ola Olsson
Karl Lunsjö
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2019
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-019-2520-5

Other articles of this Issue 1/2019

BMC Musculoskeletal Disorders 1/2019 Go to the issue