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Anatomical retraction of the semitendinosus muscle following harvest of the distal semitendinosus tendon for ACL reconstruction

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Retraction of semitendinosus muscle has been reported after reconstruction of the anterior cruciate ligament with semitendinosus/gracilis-graft. However, very little data exist on the natural variation in side-to-side length symmetry. The purpose of this study was to investigate the side-to-side asymmetry of semitendinosus muscle length in individuals with ACL reconstruction (ACLR) using the semitendinosus/gracilis-graft compared to a group of healthy control subjects to establish the level of retraction that can confidently be ascribed the surgery.

Methods

Eleven subjects aged 30 (19–39) years, with previous unilateral ACLR with the combined semitendinosus/gracilis tendon graft were recruited. Average follow-up was 6.8 years (0.3–13.0) after reconstruction. Ten healthy subjects aged 30 years (23–36) with no previous knee surgery served as controls. Bilateral magnetic resonance imaging (MRI) scans were obtained of the thigh from 60 mm below the knee joint and 700 mm proximal to this point with a slice thickness of 5 mm with 5 mm inter-slice distance. Semitendinosus length was measured on both legs between the distal and proximal musculotendinous junction of the semitendinosus. Length difference between legs was calculated for all participants. Percentage of shortening was expressed relative to the healthy leg.

Results

Subjects who had undergone ACLR had on average 81 mm (25%) shortening of the semitendinosus on the reconstructed leg compared to the non-reconstructed side. The healthy subjects all had less than 10 mm difference between legs (< 3%). The side-to-side difference was significantly different between the reconstructed patients and the healthy subjects (p < 0.001).

Conclusion

This study indicates that retraction larger than 10 mm is a consequence of the tendon harvest and not natural variation. It also supports that persistent retraction of the semitendinosus muscle occurs following harvest of the semitendinosus tendon for ACL graft.

Level of evidence

Level IV.

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Abbreviations

ACL:

Anterior cruciate ligament

ACLR:

Anterior cruciate ligament reconstruction

ST/GR-graft:

Semitendinosus/gracilis-graft

ST:

Semitendinosus

CON:

Control group

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Funding

No external funding was acquired for this project.

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Authors and Affiliations

  1. Human Movement Analysis Laboratory, Copenhagen University Hospital, Hvidovre, Amager, Denmark

    M. B. Speedtsberg & H. B. Lauridsen

  2. Department of Physiotherapy, Faculty of Health and Technology, University College Copenhagen, Hvidovre, Denmark

    M. K. Zebis

  3. Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital, Hvidovre, Amager, Denmark

    E. Magnussen

  4. Sports Orthopedic Research Center – Copenhagen (SORC-C), Department of Orthopedic Surgery, Copenhagen University Hospital, Amager-Hvidovre Hospital, Kettegård Alle 30, 2650, Hvidovre, Amager, Denmark

    M. B. Speedtsberg & P. Hölmich

Authors
  1. M. B. Speedtsberg
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  2. M. K. Zebis
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  3. H. B. Lauridsen
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  4. E. Magnussen
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  5. P. Hölmich
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Contributions

MKZ, HBL, EM and PH: study design. MBS and HBL: participant inclusion. HBL and EM: data collection. MBS and HBL: data analysis. MBS: text author. MBS, MKZ, HBL, EM and PH: manuscript editing.

Corresponding author

Correspondence to P. Hölmich.

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Conflict of interest

No conflicts of interest were declared.

Ethical approval

The project was exempt from ethical approval by the The Regional Committee on Bioethics for the Capital Region, Denmark (Jr. Nr. 17027313).

Informed consent

Informed consent for analysis and publication of data was given by all subjects.

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Speedtsberg, M.B., Zebis, M.K., Lauridsen, H.B. et al. Anatomical retraction of the semitendinosus muscle following harvest of the distal semitendinosus tendon for ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 30, 1706–1710 (2022). https://doi.org/10.1007/s00167-021-06718-1

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  • DOI: https://doi.org/10.1007/s00167-021-06718-1

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