Mid-Term Results after Anterior Cruciate Ligament Reconstruction Using Four-Strand Single Semitendinosus Tendon / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the mid-term results after anterior cruciate ligament (ACL) reconstruction using a single four-strand semitendinosus tendon. MATERIALS AND METHODS: We evaluated 81 patients (84 cases) who had undergone ACL reconstruction using an autologous single four-strand semitendinosus tendon. The patients consisted of 77 men and 4 women with a mean age of 28.8 years (15-59 years) years. Most injuries were sports related, and the largest number of cases occurred during a soccer game (38 cases). Combined injuries were meniscus injuries in 43 cases, cartilage injuries in 6 cases and medial collateral ligament injuries in 8 cases. Femoral fixation device was PINN-ACL CrossPin in 44 cases and extracortical suspension device in 40 cases. Suture tie around a screw post and an additional bioabsorbable screw were used for tibial fixation. The mean time from injury to surgery was 9+/-16 months (7 days-10 years) and the mean follow-up period was 72.0+/-8.3 months (53-95 months). Clinical evaluation was performed using Lachman test, pivot-shift test, KT-2000 arthrometer, Lysholm score, Tegner activity score, International Knee Documentation Committee (IKDC) score and return to pre-injury sports activity. Radiologic evaluation was performed using plain radiographs to evaluate joint space narrowing. RESULTS: All patients showed normal range of motion at the final follow-up. The Lachman test was positive in 4 cases, and pivot-shift test was positive in 3 cases. Lysholm score improved from 76.7 to 92.2, Tegner activity score improved from 5.1 to 6, IKDC score improved from 72.0 to 86.5, and mean anterior translation by KT-2000 improved from 7.4 mm to 2.3 mm, and 80.2micro of patients returned to pre-injury sports activity. No significant differences in joint space narrowing were observed in plain radiographs. CONCLUSION: In this study, good results were obtained after ACL reconstructions using the autologous four-strand single semitendinosus tendon with maintaining the joint stability at mid-term follow-up.

Single-Bundle Anterior Cruciate Ligament Reconstruction with Semitendinosus Tendon Using the PINN-ACL CrossPin System: Minimum 4-Year Follow-up

PURPOSE: This study evaluated mid-term results of anterior cruciate ligament (ACL) reconstruction using the PINN-ACL CrossPin system that allowed for short graft fixation. MATERIALS AND METHODS: Forty-three patients underwent single-bundle ACL reconstruction with a 4-strand semitendinosus tendon graft using the PINN-ACL CrossPin system. Femoral fixation was done using the PINN-ACL CrossPin system, and the tibial side was fixed with post-tie and a bioabsorbable interference screw. The mean follow-up period was 50 months. Evaluation was done using the Lachman test, pivot-shift test, International Knee Documentation Committee (IKDC) score and grade. Anterior displacement was assessed. RESULTS: There was improvement in the Lachman test and pivot-shift test at final follow-up, form grade II (n=40) or III (n=3) to grade I (n=3) or 0 (n=40) and from grade I (n=20) or II (n=10) to grade I (n=8) or 0 (n=22), respectively. The mean IKDC score was 88.7, and grade A and B were 93.0% at final follow-up. Side-to-side difference was improved from 6.7 mm to 2.1 mm at final follow-up. Complications occurred in 3 patients, a re-ruptured due to trauma at 2 years after surgery and a deep infection and a superficial infection. CONCLUSIONS: The mid-term follow-up results of ACL reconstruction with the PINN-ACL CrossPin system were satisfactory. The PINN-ACL CrossPin can be considered as a useful instrument for short graft fixation.

Isolated Semitendinosus Tendon Rupture in Non Athlete / 대한스포츠의학회지

Isolated rupture of distal semitendinosus is reported rarely. Here, we report a case of 51-year-old previous healthy working man diagnosed with isolated semitendinosus tendon rupture treated successfully by conservative management.

Muscle Infarction and Calcification of the Semitendinosus Tendon: A Case Report / 대한골관절종양학회지

The most common anatomic location of calcific tendinitis is the suprasupinatus muscle of the shoulder joint. However, it is known to develop in any joint including the hip, knee. Infarction of skeletal muscle in the distal areas of the limbs due to vascular occlusion is a well recognized systemic condition in patients who have diabetes. The author experienced mass-like lesion combined muscle infarction and calcification within pure semitendinosus tendon without diabetes in posterosuperior area of distal thigh in old age.

Anatomic Reconstruction of the Lateral Ankle Instability Using the Semitendinosus Allograft Tendon and Interference Screws / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical outcome of the anatomic reconstruction of the lateral ankle instability using the semitendinosus allograft tendon and the interference screws. MATERIALS AND METHODS: This study is based on the 12 feet of lateral ankle instability that had been treated with anatomic reconstruction of the anterior talofibular ligament (ATFL) and calcaneofibular ligament (CFL) using the semitendinosus allograft tendon and the interference screws. The majority of patients were young and physically active. We evaluated the patients' VAS pain scores, AOFAS scores and Karlsson-Peterson ankle scores for the 11 feet involved with at least 12 months follow up, both pre- and post-operative. In addition, we evaluated patient satisfaction. We measured the talar tilt angles and the talar anterior translations from ankle stress views. RESULTS: The average age at surgery was 25.9 years old (19-57 years); patients had symptoms of recurrent sprain for average 31.4 months before surgery. The average follow up period was 14 months. For reconstruction, we used 4.0mm thick allograft semitendinosus tendon and interference screws. VAS pain scores decreased from 6.0 to 1.1 (p<0.05) and AOFAS scores improved from 70.4 to 90.4 postoperatively (p<0.05). Karlsson-Peterson ankle scores improved significantly from 54.6 to 92.4 (p<0.05). Radiographic talar tilt decreased from 15.7degrees to 3.2degrees postoperatively (p<0.05). Eighy-two percent of the patients were satisfied with the results and the patients had returned to their jobs by 3.7 months after surgery. CONCLUSION: Anatomic reconstruction of the ATFL and the CFL in the lateral ankle instability patients using the semitendinosus tendon and the interference screws is an ideal surgical option especially for young athletes with high grade instabilities.

Clinical Evaluation of Anterior Cruciate Ligament Reconstruction with Remnant-preserving Technique: Method Using Single Four-strand Semitendinosus Tendon / 대한정형외과학회잡지

PURPOSE: We evaluated the functional and clinical results of anterior cruciate ligament (ACL) reconstruction with remnant-preserving technique using an autologous single four-strand semitendinosus tendon. MATERIALS AND METHODS: We evaluated 70 patients who had undergone ACL reconstruction using autologous single four-strand semitendinosus tendon. Group I (n=34) were cases in which more than half of the ACL remnant remained. Group II (n=36) included cases in which the ACL was nearly absent. The mean follow-up period was 18.7 months for group I cases, and 20.7 months in group II cases. We performed clinical evaluation using the following tests: Lachman test, pivot shift test, Lysholm score, Tegner activity score, and IKDC score; functional evaluation was performed using the single limb standing test and ability to return to pre-injury sports activity. RESULTS: Lachman test, pivot-shift test, measurement of side-to-side difference using KT-2000 arthrometer and Tegner activity scores were much improved over preoperative evaluations, and there were no statistically significant differences between the 2 groups. The objective IKDC (International Knee Documentation Committee) score and return to pre-injury sports activity showed no statistical difference between the 2 groups, but the subjective IKDC score (p=0.007) and Lysholm score (p=0.001) were better in group I than in group II. There was no difference in the single limb standing test and there was no difference between the 2 groups, but there was a tendency to have improved over the preoperative evaluation. CONCLUSION: We obtained good results after ACL reconstruction using the autologous single four-strand semitendinosus tendon. ACL remnant preserving group had better Lysholm score and IKDC subjective score.

Medial patellofemoral ligament reconstruction with semitendinosus tendon autograft for the treatment of patellar dislocation with arthroscopic-assisted / 中国医师进修杂志

Objective To evaluate the clinical effects of medial patellofemoral ligament reconstruction using the semitendinosus tendon autograft for the treatment of the patellar dislocation.Methods From January 2007 to January 2010,16 cases of patellar dislocation were included in this group.Lysholm score was averaged preoperatively.Arthroscopic-assisted in the semitendinosus tendon autograft reconstruction of the medial patellofemoral ligament,the central graft were fixed on the inner edge of the patellar in the upper 1/3 and the mid-point location,the end were fixed on the channel of femoral epicondyle and adductor tubercle.Results All the patients that lined progressive knee rehabilitation after operation,returned to normal walking for 3 months,6 months could be sports.Followed up for 7-54( 26.36 ± 20.48 ) months,all of patients incision were healed as grade Ⅰ,knee function were normal.Postoperative Lysholm score (93.21 ± 4.68) scores compared with preoperative ( 76.53 ± 8.35 ) scores was significant difference (P ＜ 0.05 ).Conclusions Using the semitendinosus tendon autograft for the treatment of the patellar dislocation method is simple and can effectively restore normal patellar trajectory.At the same time,which is an effective surgical method to treat recurrentdislocation of the patellar.

Free Semitendinosus Tendon Graft in Re-ruptured Achilles Tendon / 대한족부족관절학회지

The acute Achilles tendon rupture usually occurs to the people who participate in sports-related activities between 30 and 40 years of age. Recently surgical repair is the standard treatment in acute Achilles tendon rupture. After the Achilles tendon rupture in the left ankle, a 30-years old young man had been suffered from re-rupturing within three months after the primary repair. 2 years later, right-side Achilles tendon was reruptured after primary repair consequently. In the revision surgery, we performed V-Y advancement of the gastrocnemius-soleus fascia and reinforcement of the semitendinosus tendon. None of the English-literature was reported about using the semitendinosus tendon in revision surgery of the Achilles tendon retear previously. Therefore, we report this case and surgical technique because of the simple technique and the excellent results.

Snapping Knee caused by the Semitendinous Tendon: A Case Report / 대한정형외과학회잡지

Snapping syndrome has rarely been reported in the knee. A snapping knee mainly occurs in the case of a translation of the lateral meniscus or a lateral discoid meniscus. Other causes include biceps femoris tendon, semitendinosus iliotibial band, and popliteus tendon. We recently experienced a case of a snapping knee caused by the semitendinosus tendon passing over the medial tibial condyle as a result of trauma.

Arthroscopic ACL Reconstruction with Quadrupled Semitendinosus Tendon and endobutton / 대한정형외과학회잡지

In anterior cruciate ligament (ACL) deficient knee, several treatment methods were recommended. Recently, arthroscopic reconstruction is widely used as the best treatment method. As the graft materials, bone-patellar tendon-bone (BPB) unit is a gold standard material. Whereas, it has many problems. The purpose of this study was to introduce the new arthroscopic ACL reconstruction technique with quadrupled semitendinosus tendon and Endobutton and to evaluate its results. Twenty one patients were prospectively reviewed after ACL reconstruction with quadrupled semitendinosus tendon and Endobutton at one year post-operation. The surgery was performed in the series of graft tendon harvest, graft preparation, tunnel drilling and Endobutton fixation. The outcomes showed improved knee functions. Endobutton technique with quadrupled semitendinosus tendon is useful method for the arthroscopic ACL reconstruction. Stability and functional outcomes were similar to those with patellar tendon but it showed less donor site morbidity, less pitfall of fixation and simple procedure.

PCL Reconstruction Using Semitendinosus Tendon / 대한정형외과학회잡지

The posterior cruciate ligament(PCL) is one of the most important structures in the knee joing because it provides about 94% of the total restraint to posterior displacement of the tibia & posterior stability of the knee joint. If the posterior instability persisted, rotational instability, injury to meniscus and degenerative change develop within several years. The purpose of this study is to know the result of the posterior cruciate ligament reconstruction using semitendinosus tendon and to know the factors which affected to good result. During the period from January 1989 to December 1994, 16 cases with posterior cruciate ligament reconstruction using semitendinosus tendon were evaluated clinical and radiological results retrospectively and performed stastical analysis using the SPSS. The results were as follows; 1. The average preoperative posterior laxity was 14.1 mm and average postoperative laxity was 6.3 mm. It was improved 7.8 mm. 2. In other associated injured ligament group with or without fracture, above good was in 8 cases and below fair in 6 cases, but there was no significant difference between the two (X²=9.8, df=1, P>0.05). 3. In the poor result group, mean body weight was 80(±13.23)kg and there was significant difference between poor group & fair, good, excellent group(F=3.52, P < 0.05). From these results it would be suggested that PCL reconstruction using semitendinosus tendon is more effective in relatively light weighted group than heavier group.

Comparative study on intermediate-term clinical effects of different methods in arthroscopy assisted anterior cruciate ligament reconstruction / 中华创伤杂志

Objective To study the 2-4 years intermediate-term clinical effects of bone-patellar tendon-bone (B-PT-B) autograft plus interface screw method and quadruple semitendinosus tendon autograft plus endobutton plate fixation method in anterior cruciate ligament (ACL) reconstruction after ACL injury and to estimate the correlation of various implants and fixation techniques with clinical effect. Methods A retrospective analysis was done on 104 cases with ACL injury as well as detailed clinical data from October 1998 to October 2000. ACL reconstruction with bone-patellar tendon-bone autograft (PT group) and kurosaka interface screw fixation were performed in 55 cases and quadruple semitendinosus tendon autograft and endobutton plate fixation (ST group) in 49 cases. The average follow up was 38.5 months in the PT group and 35.7 months in the ST group. We compared the intermediate myodynamic recovery, ROM, lachman test, pivot shift test, IKDC score, lysholm score, Werner score and X-ray view of tunnul enlargement between two groups. Results In the PT group, the circumference of thigh was (1.097?0.079) cm, shorter than that of normal side, and (0.896?0.126) cm in the ST group. The cases accounting for 82% (45/55) in the PT group and 88% (43/49) in the ST group had extension limitation less than 3?. Knee flexion limitation of 0?-5? accounted for 87% (48/55) in the PT group and 86% (42/49) in the ST group. Bilateral comparison of Lachman test less than 5 mm accounted for 93% (51/55) in the PT group and 96% (47/49) in the ST group. Negative rate of pivot shift test was 89% (47/55) in the PT group and 92% (45/49) in ST group. Bilateral comparison of AP knee laxity with 20Ib KT-1000 in laxity with less than 3 mm accounted for 53% (29/55) in the PT group and 57% (28/49) in the ST group. Lyoholm score in the PT group was increased from preoperative 69.2?6.4 to postoperative 86.7?4.3 and that in the ST group from 68.3?7.5 to 88.4?8.6. Knee motion standard of IKDC score in the PT group was 78%(43/55), which was found normal or nearly normal, and 82%(40/49) in the ST group. Patellar femoral pain Werner score was 43.0 ?6.1 in the PT group while 45.0?6.3 in the ST group. The X-ray showed that tunnel enlargement phenomena was 53% (29/55) in the PT group while 43% (21/49) in the ST group. Conclusions From 2-4 years intermediate-term follow up, there is no significant difference in ACL reconstruction using patellar tendon autograft plus interface screw method and quadruple semitendinosus tendon plus endobutton plate fixation method. Bone grafting in the donor site can reduce the incidence of anterior knee pain. Twisting technique is beneficial to overcome of the postoperative laxity caused by viscular elasticity of quadruple semitendinosus.