Partial harvesting technique in anterior cruciate ligament reconstruction with autologous semitendinosus tendon to prevent a postoperative decrease in deep knee flexion torque.

BACKGROUND: A significant decrease in deep knee flexion torque has been reported after harvesting the semitendinosus tendon for anterior cruciate ligament (ACL) reconstruction. Thus, we have developed a partial harvesting technique that leaves part of the width of the insertion of semitendinosus tendon by splitting it. Our hypothesis was that the partial harvesting technique would reduce postoperative functional deficits in deep knee flexion by achieving regeneration of harvested tendon without shortening. METHODS: A total of 36 patients who underwent ACL reconstruction with an autologous semitendinosus tendon by means of either the conventional whole harvesting technique (whole-ST group, n=16) or the partial harvesting technique (partial-ST group, n=20) were included in this study. Clinical outcome, semitendinosus muscle length, and deep knee flexion torque were assessed 2 years after surgery. RESULTS: No significant group differences were found in terms of range of motion, Lysholm score, or anterior knee laxity. Shortening of the semitendinosus muscle was significantly less in the partial-ST group (mean 8mm) than in the whole-ST group (mean 36 mm; P<0.001). The side-to-side ratio of isometric knee flexion torque in the prone position with 90° of knee flexion was statistically different between the partial-ST (87.0 ± 20.4%) and whole-ST (55.3 ± 13.9%; P<0.001) groups. CONCLUSIONS: The present partial harvesting technique not only prevented shortening of the semitendinosus muscle, but also reduced the deficit in the maximum knee flexion angle in the standing position and a decrease in the deep knee flexion torque in the prone position with the partial harvesting technique compared to the nonoperated side with good clinical outcomes. LEVEL OF EVIDENCE: Case-control study, Level III.

Anti-Chol-1 antigen, GQ1bα, antibodies are associated with Alzheimer's disease.

The interaction of amyloid ß-proteins (Aß) with membrane gangliosides has been reported to be an early event in Aß fibril formation in Alzheimer's disease (AD). Neuronal degeneration in AD has been postulated to be associated with the presence of anti-ganglioside antibodies in patient sera. Using an enzyme-linked immunosorbent assay (ELISA) and high-performance thin-layer chromatography (HPTLC) immunostaining, sera from 27 individuals (10 with AD, 6 with vascular dementia (VD), and 11 non-demented age-matched pathological controls) were examined in order to detect anti-glycosphingolipid (GSL) antibodies, including anti-cholinergic-specific antigen (Chol-1α; GQ1bα) antibodies. All sera had natural antibodies against ganglio-N-tetraosyl gangliosides (brain-type gangliosides). However, sera of demented patients with AD and VD had significantly higher titers of anti-GSL antibodies than those in age-matched pathological controls. Although most serum antibodies, including anti- GM1, -GT1b, -GQ1b, -GQ1bα, were of the IgM type, the presence of the IgG type antibodies was also significantly elevated in the sera of demented patients with AD. Anti-GT1b antibodies of the IgG type were elevated in AD (90%, 9 of 10 cases) and VD (100%), respectively. Most surprisingly, anti-GQ1bα antibodies (IgM) were found in 90% (9/10) and 100% (6/6) in the sera of patients with AD and VD, respectively. Since GQ1bα is present in the cerebral cortex and hippocampus, the presence of anti-GQ1bα antibodies may play an important role in disrupting cholinergic synaptic transmission and may participate in the pathogenesis of dementia. We conclude that elevated anti-GSL antibody titers may be useful as an aid for clinical diagnosis of those dementias.