Influence of Medial Hamstring Tendon Harvest on Knee Flexor Strength after Anterior Cruciate Ligament Reconstruction

2003 ◽  
Vol 31 (4) ◽  
pp. 521-529 ◽  
Author(s):  
Toshiyuki Tashiro ◽  
Hisashi Kurosawa ◽  
Akira Kawakami ◽  
Atsuhiko Hikita ◽  
Naoshi Fukui
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Strength ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Knee Flexion ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Hamstring Muscle ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Background The advantages of hamstring tendon autografts for anterior cruciate ligament reconstruction are well known; however, concerns have arisen regarding the influence of hamstring tendon harvest on postoperative weakness in knee flexion. Purpose To evaluate the influence of hamstring tendon harvest on knee flexion strength in patients undergoing anterior cruciate ligament reconstruction. Study Design Prospective randomized study. Methods Ninety patients were randomly assigned at surgery to undergo anterior cruciate ligament reconstruction with either a semitendinosus tendon autograft or a semitendinosus and gracilis tendon autograft. Quadriceps and hamstring muscle strength was tested before surgery and at 6, 12, and 18 months after surgery. Results There was no significant difference in clinical results between the groups and neither group showed a significant decrease in isokinetic hamstring muscle strength. However, when the subjects’ knees were at positions of 70° or more of flexion, both isokinetic and isometric measurements revealed a significant decrease in hamstring muscle strength in both groups. The strength in the group with semitendinosus and gracilis tendons was considerably less than that in the group with semitendinosus tendon alone at 18 months. Conclusions Tendon harvest causes significant weakness of hamstring muscle strength at high knee flexion angles, but such weakness can be minimized if the gracilis tendon is preserved.

Gait Patterns after Anterior Cruciate Ligament Reconstruction are Related to Graft Type

2005 ◽  
Vol 33 (2) ◽  
pp. 247-254 ◽  
Author(s):  
Kate E. Webster ◽  
Joanne E. Wittwer ◽  
Jason O'Brien ◽  
Julian A. Feller
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Patellar Tendon ◽  
Knee Flexion ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Donor Site ◽  
Hamstring Tendon ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Background Although there is a tendency toward gait normalization after anterior cruciate ligament reconstruction, altered moments about the knee flexion-extension axis have been reported. It is possible that these gait alterations relate to donor site morbidity associated with the graft harvest. Hypothesis There is a relationship between graft type and external knee moments during walking. Study Design Controlled laboratory study. Methods Three groups were compared: 17 patellar tendon anterior cruciate ligament reconstruction patients (mean, 11 months after surgery), 17 hamstring tendon anterior cruciate ligament reconstruction patients (mean, 9.3 months after surgery), and 17 matched controls. A 3-dimensional motion analysis and force plate system was used to determine sagittal plane kinematics and kinetics of the lower limb during comfortable-speed walking. Results There were significant differences in the moments about the knee that related to graft type. The external knee flexion moment at midstance was significantly smaller than that in the control knees in 65% of patients in the patellar tendon group and 29% of patients in the hamstring tendon group. In contrast, the external knee extension moment at terminal stance was significantly smaller than that in the control knees in 53% of subjects in the hamstring tendon group and 23% of subjects in the patellar tendon group. Conclusions There are graft-specific differences in knee biomechanics after anterior cruciate ligament reconstruction that appear to relate to the donor site. Clinical Relevance Considerable debate continues as to whether the patellar tendon or the hamstring tendon graft is preferable for anterior cruciate ligament reconstruction. It is therefore clinically relevant to understand the biomechanical differences in knee function associated with both graft types.

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