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Document Title: Segawa-AJARS-Feb02.shtml
Article Title: Rotational Muscle Strength of the Limb After Anterior Cruciate Ligament Reconstruction Using Semitendinosus and Gracilis Tendon
Authors: Hiroyuki Segawa, M.D., Go Omori, M.D., Yoshio Koga, M.D., Touru Kameo, P.T., Satoshi Iida, P.T., and Masaei Tanaka, P.T.
Publication: Arthroscopy: The Journal of Arthroscopic and Related Surgery
Date: February 2002
Volume 18, Number 2, pages 177-182
Keywords: ACL reconstruction, hamstring autograft, DLSTG graft, rotational muscle strength.
(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form, complete with all figures and tables.)
Comments: This article is a must-read for anyone who is contemplating (or who has undergone) ACL reconstruction via hamstring autografting. The first two paragraphs of the discussion are razor-sharp; if you are tight for time, at least be sure to read those two paragraphs.
ABSTRACT
Purpose: To investigate the influence of harvesting semitendinosus and gracilis tendons on the rotational muscle strength of the limb after anterior cruciate ligament (ACL) reconstruction.
Type of Study: Prospective study.
Methods: We performed a prospective study of 62 consecutive (34 male, 28 female) patients with ACL reconstructions using the semitendinosus and gracilis tendons. The mean age at surgery was 20.8 years. The semitendinosus tendon was harvested in 32 patients (ST group), and semitendinosus and gracilis tendons in 30 patients (STG group). The peak isokinetic torques for extension, flexion, internal rotation, and external rotation were measured before and 12 months after ACL reconstruction using the Cybex 6000B system (Cybex Division of Lumex, Ronkonkoma, NY). The rotational torque was measured at 30°/sec and 120°/sec.
Results: Before reconstruction, the mean isokinetic peak torque of the involved limb was decreased in extension and internal rotation. The mean isokinetic peak torque of the involved limb in extension recovered 12 months after ACL reconstruction; however, the weakness in internal rotation persisted. The preoperative weakness of the involved limb in extension and internal rotation recovered in the male patients, but not in the female patients after postoperative rehabilitation. The peak torque of the involved limb in internal rotation was decreased in the STG group, but not in the ST group.
Conclusions: The internal rotational torque was influenced by harvesting the semitendinosus and gracilis tendons after ACL reconstruction, especially in female patients and patients from whom the gracilis tendon was harvested. Semitendinosus and gracilis tendons are important for the internal rotation of the limb and it was difficult to compensate for this function. Thus, we recommend harvesting the semitendinosus tendon only if tendon quality is sufficient to further minimize harvesting morbidity.
Key Words: Anterior cruciate ligament—Reconstruction—Rotational muscle strength—Semitendinosus tendon—Gracilis tendon.
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