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Isolated gracilis tendon harvesting is not associated with loss of strength and maintains good functional outcome

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The gracilis tendon is a commonly used autologous graft. Most information on knee function and outcomes after its harvest is related to both semitendinosus- and gracilis tendon harvest. Therefore this study analyzed the effect of isolated gracilis tendon harvest from healthy, uninjured knees on thigh muscle strength and patient reported outcome measures (PROMs).

Methods

Stabilization of the acromioclavicular joint because of chronic instability was performed with autologous gracilis tendon in 12 patients. After a mean of 44 ± 25 months after surgery, isokinetic peak-torque measurements of specific functions of the gracilis muscle were performed: knee flexion in a sitting position (flexion angles 0–90°) and in prone position (flexion angles > 70°), internal tibial rotation and hip adduction. The contralateral limb was control. Knee specific PROMs were collected including IKDC-2000 subjective evaluation form, Lysholm score, the Marx Activity Rating Scale and SF-36 health survey.

Results

No significant side-to-side differences were found regarding torque measurements. Excellent results were shown regarding the PROMs, which even in terms of IKDC-2000 (97 vs. 82 points, p = 0.001) exceeded significantly the age- and gender matched reference-data.

Conclusion

Isolated gracilis tendon harvesting was not associated with loss of strength in knee flexion, internal tibial rotation and thigh adduction. Additionally, good functional outcome as well as excellent knee-specific subjective outcome was found.

Level of evidence

III.

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Author information

Authors and Affiliations

  1. Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Berlin, Germany

    Anne Flies & Markus Scheibel

  2. Clinic and Outpatient Clinic for Orthopaedics and Orthopaedic Surgery, University Medicine, Greifswald, Germany

    Natascha Kraus

  3. Department of Plastic, Aesthetic and Reconstructive Microsurgery/Hand Surgery, Hospital Ernst Von Bergmann, Potsdam, Germany

    Philipp Kruppa

  4. The Steadman Clinic, Vail, CO, USA

    Matthew T. Provencher

  5. Center of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Hospital Brandenburg an der Havel, Hochstraße 29, 14770, Brandenburg an der Havel, Germany

    Roland Becker & Sebastian Kopf

Authors
  1. Anne Flies
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  2. Markus Scheibel
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  3. Natascha Kraus
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Corresponding author

Correspondence to Sebastian Kopf.

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Conflict of interest

Author M. T. Provencher received IP royalties and speaker fees from Arthrex Inc. as well as consulting fees from Slack Inc. and Joint Research Foundation. All other authors declare that they have no conflict of interest.

Funding

This work was funded by the AGA—Society for Arthroscopy and Joint Surgery under research Grant No. 63.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Informed consent

Informed consent was obtained from all individual participants for whom identifying information is included in this article.

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Research performed at Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-University Medicine Berlin.

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Flies, A., Scheibel, M., Kraus, N. et al. Isolated gracilis tendon harvesting is not associated with loss of strength and maintains good functional outcome. Knee Surg Sports Traumatol Arthrosc 28, 637–644 (2020). https://doi.org/10.1007/s00167-019-05790-y

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  • DOI: https://doi.org/10.1007/s00167-019-05790-y

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