Anterior cruciate ligament reconstruction using a hamstring graft: a retrospective comparison of tunnel widening upon use of two different femoral fixation methods

2014 ◽  
Vol 23 (8) ◽  
pp. 2283-2291 ◽  
Author(s):  
Musa Ugur Mermerkaya ◽  
Ozgur Ahmet Atay ◽  
Burak Kaymaz ◽  
Senol Bekmez ◽  
Fatih Karaaslan ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Tunnel Widening ◽  
Hamstring Graft ◽  
Femoral Fixation ◽  
Cruciate Ligament Reconstruction ◽  
Retrospective Comparison ◽  
Anterior Cruciate

Tunnel Widening after Anterior Cruciate Ligament Reconstruction

2009 ◽  
Vol 37 (8) ◽  
pp. 1609-1617 ◽  
Author(s):  
Alexandra Neddermann ◽  
Elmar Willbold ◽  
Frank Witte ◽  
Christof Hurschler ◽  
Stefan Hankemeier ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Bone Volume ◽  
Tunnel Widening ◽  
Tunnel Enlargement ◽  
Cruciate Ligament Reconstruction ◽  
Anteroposterior Translation ◽  
Anterior Cruciate

Background A common clinical concern after anterior cruciate ligament reconstruction is the expansion of the bone tunnels as seen radiographically. The etiology and clinical relevance of this phenomenon remain unclear. Hypothesis Tunnel widening results in an increased anteroposterior translation, and there are specific histologic changes due to osteoclastic bone resorption associated with this phenomenon. Study Design Controlled laboratory study. Methods Thirty sheep (age, 4 months) underwent an anterior cruciate ligament reconstruction using a soft tissue graft. Graft fixation was achieved using the EndoButton and Suture Washer. Six animals each were sacrificed at 0, 3, 6, 12, and 24 weeks after surgery. Each anterior cruciate ligament–reconstructed knee was examined by computed tomography. Anteroposterior translation was determined using a universal force-moment sensor robot. The bone surrounding the tunnel was evaluated histologically. Results The prevalence of tunnel enlargement on the femoral side was 77.3%. Animals with tunnel widening did not demonstrate increased anteroposterior translation. Widening of the femoral tunnel was significantly associated with a higher stiffness of the graft (P <. 05) and hypertrophy of the graft throughout the remodeling process. The histologic evaluation of the bone tunnel walls demonstrated an increase of bone volume in animals with tunnel enlargement. No statistically significant correlation could be found between the number of osteoclasts and the presence of tunnel widening. Conclusion In this large animal model of anterior cruciate ligament reconstruction, animals with significant tunnel widening did not suffer increased anteroposterior translation. Tunnel widening was associated with a high stiffness of the graft, graft hypertrophy, and an increase in bone volume of the tunnel wall. Clinical Relevance The present data correspond to the current opinion in humans that tunnel widening is not associated with knee instability. Further research is needed to understand the role of graft stiffness, graft hypertrophy, and the increase in bone volume in this phenomenon.

scholarly journals Variation in Gastrocnemius and Hamstrings Muscle Activity During Peak Knee Flexor Force After Anterior Cruciate Ligament Reconstruction With Hamstring Graft: Preliminary Controlled Study

2020 ◽  
Author(s):  
Luna SEQUIER ◽  
Florian Forelli ◽  
Maude TRAULLÉ ◽  
Amaury VANDEBROUCK ◽  
Pascal Duffiet ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Muscular Activity ◽  
Medial Gastrocnemius ◽  
Hamstring Graft ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Experimental Group

Background: The optimisation of this return to athletic activity pass by a better understanding of the behaviour of the muscle involved in knee function.In this study, we focused on the muscular activity of the muscle involved in the flexion of the knee. Preciseley on the relation between the muscular activity of the gastrocnemius and the hamstring among the patient that underwent an anterior cruciate ligament reconstruction with hamstring graft.Objective : The objective of the study is to compare, the muscular activity of the flexor knee muscle in patient that underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals that have not undergone surgery.Methods : The participants have been divided into two groups : an healthy group and an experimental group that underwent an anterior cruciate ligament recontruction with hamstring graft. The participants had to performe a strenght test on a isocinetik dynamometer. The activity of the medial gastrocnemius, lateral gastrocnemius, femoral biceps and the semitendinosus were mesured during this test.The muscular activity of the muscle mentioned of the individuals in the first group were compared to the ones in the second group via a statistical analysis. Then, a ratio of the activity of the gastrocnemius muscle on the activity of the hamstring was calculated The results of the experimental group were then compared to the results of the control groupResults : The results showed a significative difference activity of the medial gastrocnemius, the femoral biceps and the semitendinosus muscles : the experimental group results were superior to the control group results However the evaluation of the activity reporting has shown significant differences in the two groupsConclusion : This study has allowed us to show a difference in muscular activity of the gastrocnemius and hamstring muscle between patient that underwent an anterior cruciate ligament reconstruction surgery and the heathy participants. However our approch has not allowed us to identify the relation between a heihtened gastrocnemius activity and a diminished hamstring activity following an anterior cruciate ligament reconstruction with hamstring graft. Quite on the contrary, we observed a higher activity of the two muscle groups. Nevertheless, it seem to be necessary to have a variation in situations during the analysis of the gastrocnemius muscle to fully understans its purpose in the functional activity of the knee of patient that have undergone an anterior cruciate ligament reconstruction.

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