Advertisement

International Orthopaedics

, Volume 37, Issue 2, pp 279–284 | Cite as

Long-term outcome of anterior cruciate ligament reconstruction with an autologous four-strand semitendinosus tendon autograft

  • Nikolaus A. Streich
  • Sebastian Reichenbacher
  • Alexander Barié
  • Matthias Buchner
  • Holger Schmitt
Original Paper

Abstract

Purpose

Although the short- and mid-term outcomes of ACL reconstruction with a hamstring graft are promising, clinical investigations reporting the long-term results after ten years or longer are rare. Therefore we performed a retrospective single-blinded evaluation of ACL reconstruction using a four-stranded single-bundle reconstruction with a semitendinosus tendon graft with extracortical fixation.

Methods/Results

At follow-up patients obtained at least the same level in the clinical outcome scores (Lysholm, IKDC, Tegner) compared to previous studies with a similar follow-up time using a STG graft. Furthermore there was no detectable difference in the incidence of osteoarthritis. Patients having a negative pivot shift test showed significantly fewer signs of radiographic osteoarthritis and better functional assessment scores.

Conclusion

On the basis of our investigation, we conclude that the reconstruction of the ACL by a quadrupled semitendinosus tendon graft with extracortical anchorage can achieve excellent clinical and subjective results after a follow-up of ten years.

Keywords

Numeric Rating Scale Femoral Tunnel Pivot Shift International Knee Documentation Committee Pivot Shift Test 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    National Institutes of Health (NIH) (2007) Prognosis and predictors of ACL reconstruction—a multicenter cohort study. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), Vanderbilt University, United States. Available at: http://clinicaltrials.gov/ct2/show/NCT00463099. Accessed March 1, 2011
  2. 2.
    Prodromos CC, Han YS, Keller BL, Bolyard RJ (2005) Stability results of hamstring anterior cruciate ligament reconstruction at 2- to 8-year follow-up. Arthroscopy 21(2):138–146PubMedCrossRefGoogle Scholar
  3. 3.
    Hospodar SJ, Miller MD (2009) Controversies in ACL reconstruction: bone-patellar tendon-bone anterior cruciate ligament reconstruction remains the gold standard. Sports Med Arthrosc 17(4):242–246PubMedCrossRefGoogle Scholar
  4. 4.
    Mohtadi NG, Chan DS, Dainty KN, Whelan DB (2011) Patellar tendon versus hamstring tendon autograft for anterior cruciate ligament rupture in adults. Cochrane Database Syst Rev 7(9):CD005960Google Scholar
  5. 5.
    Reinhardt KR, Hetsroni I, Marx RG (2010) Graft selection for anterior cruciate ligament reconstruction: a level I systematic review comparing failure rates and functional outcomes. Orthop Clin North Am 41(2):249–262PubMedCrossRefGoogle Scholar
  6. 6.
    Chen L, Cooley V, Rosenberg T (2003) ACL reconstruction with hamstring tendon. Orthop Clin North Am 34:9–18PubMedCrossRefGoogle Scholar
  7. 7.
    LaValley MP, McAlindon TE, Chaisson CE, Levy D, Felson DT (2001) The validity of different definitions of radiographic worsening for longitudinal studies of knee osteoarthritis. J Clin Epidemiol 54(1):30–39PubMedCrossRefGoogle Scholar
  8. 8.
    Beynnon BD, Johnson RJ, Fleming BC, Pekka K, Kaplan M, Samni J et al (2002) Anterior cruciate ligament replacement: comparison of bone- patellar tendon-bone grafts with two-strand hamstring grafts. J Bone Joint Surg Am 84A:1503–1513Google Scholar
  9. 9.
    Eriksson K, Anderberg P, Hamberg P, Löfgren AC, Brendenberg M, Westman I et al (2001) A comparison of quadrupled semitendinosus and patellar tendon grafts in reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br 83:348–354PubMedCrossRefGoogle Scholar
  10. 10.
    Keays SL, Bullock-Saxton JE, Keays AC, Newcombe PA, Bullock MI (2007) A 6-year follow-up of the effect of graft site on strength, stability, range of motion, function, and joint degeneration after anterior cruciate ligament reconstruction: patellar tendon versus semitendinosus and gracilis tendon graft. Am J Sports Med 35(5):729–739PubMedCrossRefGoogle Scholar
  11. 11.
    Sajovic M, Vengust V, Komadina R, Tavcar R, Skaza K (2006) A prospective, randomized comparison of semitendinosus and gracilis tendon versus patellar tendon autografts for anterior cruciate ligament reconstruction: five-year follow-up. Am J Sports Med 34(12):1933–1940PubMedCrossRefGoogle Scholar
  12. 12.
    Gobbi A, Domzalski M, Pascual J, Zanazzo M (2005) Hamstring anterior cruciate ligament reconstruction: is it necessary to sacrifice the gracilis? Arthroscopy 21:275–280PubMedCrossRefGoogle Scholar
  13. 13.
    Marcacci M, Zaffagnini S, Giordano G, Iacono F, Presti ML (2009) Anterior cruciate ligament reconstruction associated with extra-articular tenodesis: a prospective clinical and radiographic evaluation with 10- to 13-year follow-up. Am J Sports Med 37(4):707–714PubMedCrossRefGoogle Scholar
  14. 14.
    Loh JC, Fukuda Y, Tsuda E, Steadman RJ, Fu FH, Woo SL (2003) Knee stability and graft function following anterior cruciate ligament reconstruction: comparison between 11 o’clock and 10 o’clock femoral tunnel placement. 2002 Richard O’Connor Award paper. Arthroscopy 19:297–304PubMedCrossRefGoogle Scholar
  15. 15.
    Pinczewski LA, Lyman J, Salmon LJ, Russell VJ, Roe J, Linklater J (2007) A 10-year comparison of anterior cruciate ligament reconstructions with hamstring tendon and patellar tendon autograft: a controlled, prospective trial. Am J Sports Med 35(4):564–574PubMedCrossRefGoogle Scholar
  16. 16.
    Holm I, Oiestad BE, Risberg MA, Aune AK (2010) No difference in knee function or prevalence of osteoarthritis after reconstruction of the anterior cruciate ligament with 4-strand hamstring autograft versus patellar tendon–bone autograft: a randomized study with 10-year follow-up. Am J Sports Med 38(3):448–454PubMedCrossRefGoogle Scholar
  17. 17.
    Samuelsson K, Andersson D, Karlsson J (2009) Treatment of anterior cruciate ligament injuries with special reference to graft type and surgical technique: an assessment of randomized controlled trials. Arthroscopy 25:1139–1174PubMedCrossRefGoogle Scholar
  18. 18.
    Jonsson H, Riklund-Ahlstrom K, Lind J (2004) Positive pivot shift after ACL reconstruction predicts later osteoarthrosis: 63 patients followed 5–9 years after surgery. Acta Orthop Scand 75(5):594–599PubMedCrossRefGoogle Scholar
  19. 19.
    Streich NA, Zimmermann D, Bode G, Schmitt H (2011) Reconstructive versus non-reconstructive treatment of anterior cruciate ligament insufficiency. A retrospective matched-pair long-term follow-up. Intern Orthop 35:607–613CrossRefGoogle Scholar
  20. 20.
    Kocher MS, Steadman JR, Briggs KK, Sterett WI, Hawkins RJ (2004) Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction. Am J Sports Med 32(3):629–634PubMedCrossRefGoogle Scholar
  21. 21.
    Shelbourne K, Gray T (2000) Results of anterior cruciate ligament reconstruction based on meniscus and articular cartilage status at the time of surgery. Five- to fifteen-year evaluations. Am J Sports Med 28(4):446–452PubMedGoogle Scholar
  22. 22.
    Feller JA, Webster KE (2003) A randomized comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction. Am J Sports Med 31(4):564–573PubMedGoogle Scholar
  23. 23.
    Buelow JU, Siebold R, Ellermann A (2002) A prospective evaluation of tunnel enlargement in anterior cruciate ligament reconstruction with hamstrings: extracortical versus anatomical fixation. Knee Surg Sports Traumatol Arthrosc 10:80–85PubMedCrossRefGoogle Scholar
  24. 24.
    Clatworthy MG, Annear P, Bulow JU, Bartlett RJ (1999) Tunnel widening in anterior cruciate ligament reconstruction: a prospective evaluation of hamstring and patella tendon grafts. Knee Surg Sports Traumatol Arthrosc 7:138–145PubMedCrossRefGoogle Scholar
  25. 25.
    Lidén M, Ejerhed L, Sernert N, Laxdal G, Kartus J (2007) Patellar tendon or semitendinosus tendon autografts for anterior cruciate ligament reconstruction: a prospective, randomized study with a 7-year follow-up. Am J Sports Med 35(5):740–748PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Nikolaus A. Streich
    • 1
  • Sebastian Reichenbacher
    • 1
  • Alexander Barié
    • 1
  • Matthias Buchner
    • 2
  • Holger Schmitt
    • 3
  1. 1.Department of Orthopaedic Sports MedicineUniversity of HeidelbergHeidelbergGermany
  2. 2.Praxis am LudwigsplatzKarlsruheGermany
  3. 3.Atos Clinic HeidelbergHeidelbergGermany

Personalised recommendations