scholarly journals Average Thickness of the Four Folded Hamstring Tendons Which we Use in ACL Reconstruction

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0021
Author(s):  
Çetin Işık ◽  
Nurdan Çay ◽  
Osman Tecimel ◽  
Ahmet Fırat ◽  
Mustafa Akkaya ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Hamstring Tendon ◽  
Average Thickness ◽  
Hamstring Tendons ◽  
Hamstring Autograft ◽  
Research Hospital ◽  
Tendon Reconstruction ◽  
Training And Research ◽  
Tendon Thickness ◽  
Graft Thickness

Objectives: The purpose of this study is to determine the average thickness of 4 folded hamstring tendons (autograft) which we used on our patients who had tendon reconstruction because of ACB rapture diagnostic. Methods: Between the dates of January 2009 and December 2013, patients who had tendon reconstruction with hamstring autograft because of ACB rapture diagnostic were evaluated retrospectively in Yıldırım Beyazıt University Ankara Atatürk Training And Research Hospital – Orthopaedics and Trauma Clinic. 258 patients who had 4 folded hamstring tendon which was prefered usually, were included into the study but 26 patients were not included into the study who had different autograft applications and direct allografts usages. Results: 242 of the 258 patiens who were included into the study were males and remaining 16 were females. Average age was 28.7 (14-52). The average thickness of the 4 folded hamstring tendons (semitendinosus and gracilis tendons) of the patients was observed as 7.9mm (6-10mm). The tendon thickness of 47 patients were measured below 7mm. For those patients, the tendon thickness was increased by combining allografts with autografts. Conclusion: The average thickness of the 4 folded hamstring tendons what we have used was 7.9mm. By considering the average graft thickness, it may be beneficial to make the planing by thinking about different configurations or keeping allografts ready for the cases which may require thicker grafts.

scholarly journals Bridge-Enhanced ACL Repair: Two Year Results of the First In Human Study

2019 ◽  
Vol 7 (3_suppl2) ◽  
pp. 2325967119S0019
Author(s):  
Martha M. Murray ◽  
Leslie Kalish ◽  
Braden C. Fleming ◽  
Brett Flutie ◽  
Laura Thurber ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Human Study ◽  
Hamstring Tendon ◽  
Suture Repair ◽  
Hamstring Autograft ◽  
Acl Repair ◽  
Time Points ◽  
Patient Reported ◽  
Kt 1000 ◽  
Objective Score

Objectives: The Bridge-Enhanced ACL Repair (BEAR) procedure is an alternate form of anterior cruciate ligament (ACL) surgery that involves suture repair of the ligament combined with a scaffold to bridge the gap between the torn ligament ends. In this paper, we report outcomes of this procedure and a non-randomized concurrent control group receiving ACL reconstruction with quadrupled hamstring tendon autograft. We hypothesized that patients treated with Bridge-Enhanced ACL Repair would have physical exam findings, patient reported outcomes and adverse events at one and two years that were similar to patients treated with ACL reconstruction. Methods: This was an observational cohort study. Twenty patients were enrolled. Ten patients received a Bridge-Enhanced ACL Repair (BEAR®) and 10 received a hamstring autograft ACL reconstruction. Outcomes were assessed at time points up to 2 years post-operatively, including the International Knee Documentation Committee (IKDC) Subjective Score, the IKDC Objective score, KT-1000 testing for AP laxity and functional testing. Results: There were no graft or repair failures in the first two years after surgery. The IKDC Subjective Scores in both groups improved significantly from baseline (p< 0.0001) but were similar in BEAR and ACL reconstruction groups at 12 and 24 months. An IKDC Objective score of A (normal) was found in 44% of the patients in the BEAR group and 29% of the patients in the ACL reconstruction group at two years; no patients in either group had a grade of C (abnormal) or D (severely abnormal). KT-1000 testing demonstrated a side to side difference that was similar in the two groups at 2 years (mean(±SD) 1.9(± 2.1) mm in the BEAR group, 3.1(± 2.7) mm in the ACLR group). Functional hop testing results were similar in the two groups at 1 and 2 years after surgery. Hamstring strength indices measured by dynamometer were significantly higher at all time points in the BEAR group than in the hamstring autograft group (mean percentages relative to contralateral side at two years, 98.6%(±10.5%) vs 56.3%(±19.0%), p=0.0001). Conclusion: In a small first-in-human study, Bridge-Enhanced ACL Repair produced similar outcomes to ACL reconstruction with autograft quadruple bundle hamstring tendon.

scholarly journals A Modified Oblique Incision in Hamstring Tendon Graft Harvesting During ACL Reconstruction

2020 ◽  
Author(s):  
Biao Zhu ◽  
XueLei Li ◽  
Tengteng Lou
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Sensory Loss ◽  
Functional Score ◽  
Hamstring Tendons ◽  
Prick Test ◽  
Significant Difference ◽  
Oblique Incision

Abstract Background: During anterior cruciate ligament(ACL)reconstruction, different methods of harvesting hamstring tendon may lead to different degrees of injury to the inferior patellar branch of the saphenous nerve(IPBSN). Most of recent studies in the literature suggest that the classic oblique incision(COI) can reduce the incidence of IPBSN injury. We proposed a modified oblique incision(MOI) and compared it with the COI in terms of the resulting levels of injury and sensory loss and the clinical outcome.Methods: Patients with ACL injury admitted to our hospital from April 2015 to July 2019 were randomly selected and included in our study. Thirty patients underwent the COI to harvest hamstring tendons, and the other 32 patients underwent the MOI. The pin prick test was performed to detect the sensation loss at 2 weeks, 6 months and 1 year after the operation. Digital photos of the region of hypoesthesia area were taken, and then computer software (Adobe Photoshop CS6, 13.0.1) was used to calculate the area of the hypoesthesia. The length of the incision and knee joint functional score were also recorded. Results: At the final follow-up, the incidence of IPBSN injury in COI and MOI were 33.3% and 9.4%, and the areas of paresthesia were 26.4±2.4 cm2 and 9.8±3.4 cm2 respectively. There was no significant difference in the incision length or knee functional score between the two groups.Conclusion: The MOI can significantly reduce the risk of injury to the IPBSN, reduce the area of hypoesthesia and lead to high subjective satisfaction. Therefore, compared with the COI, the MOI is a better method of harvesting hamstring tendons in ACL reconstruction.

PRP on Preventıon of Tunnel Enlargement in ACL Reconstructıon

2018 ◽  
Vol 20 (4) ◽  
pp. 285-291 ◽  
Author(s):  
Serkan Sözkesen ◽  
Huseyin Gokhan Karahan ◽  
Ahmet Kurtulmus ◽  
Cemil Kayali ◽  
Taskin Altay
Keyword(s):  
Acl Reconstruction ◽  
Platelet Rich Plasma ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Hamstring Tendon ◽  
Control Group ◽  
Tunnel Enlargement ◽  
Hamstring Autograft ◽  
Significant Difference ◽  
Kt 1000

Background. The purpose of this study is to describe the role of Platelet Rich Plasma in preventing tunnel enlargement in anterior cruciate ligament reconstruction with a hamstring autograft Material and methods. Forty-four patients who underwent transtibial reconstructive surgery with a hamstring tendon autograft between March 2014 and July 2015 were included in this study. This study involved two groups. Group A consisted of 18 patients who underwent PRPadministration into the femoral and tibial tunnel. Group B was a control group that included 26 patients who underwent ACL reconstruction surgery with a hamstring autograft without PRP. The patients were evaluated preoperatively and postoperatively with the IKDC score, Lysholm score, Tegner activity scale and a KT-1000 arthrometer device. The diameter of the tibial and femoral tunnels of the operated knees was measured on the first day and at three months postoperatively using CT. Measurements carried out for tomography standardization of the patients were evaluated on coronal, sagittal and axial images from 64-slice MSCT scans. Results. On comparison of radiological data between both groups, there was less tunnel enlargement in PRP-administered group for the femoral tunnel, but the result was not statistically significant. No difference was seen between clinical examination results and the grading scales used. Conclusions. 1. The radiological findings of our study indicated that while there was less tunnel enlargement in the PRP group, there was no statistically significant difference between the groups. 2. Similarly, clinical exa­mination results and scoring scales used did not de­monstrate any intergroup difference. 3. As a result, we donot recommend routine use of PRP for the prevention of tunnel enlargement after ACL reconstruction.

scholarly journals Intraoperative Conversion to Five-Strand Hamstring Autograft Configuration Significantly Increases Anterior Cruciate Ligament Graft Diameter Independent of Patient Characteristics

2019 ◽  
Author(s):  
Brian E. Walczak ◽  
Scott J. Hetzel ◽  
Craig Chike Akoh ◽  
Geoffrey S. Baer
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Patient Characteristics ◽  
Hamstring Tendon ◽  
Hamstring Autograft ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Intraoperative Conversion ◽  
Graft Diameter

AbstractIntraoperative conversion of a four-strand hamstring autograft to a five-strand configuration during an anterior cruciate ligament (ACL) reconstruction has been reported. However, the expected change in graft size and the dependence on patient characteristics are currently not well described. The purpose of this study was to determine the effective change in hamstring graft diameter and reliance on patient characteristics when intraoperatively converting a four-strand hamstring autograft into a five-strand configuration during an ACL reconstruction. A prospective, paired cohort study design was used to measure individual hamstring autograft diameter intraoperatively using traditional four-strand configuration followed by a five-strand configuration. All hamstring tendons included were long enough to consider a five-strand configuration. Five-strand hamstring autograft increased graft diameter in all patients. Hamstring tendon graft diameter increased by an average of 0.99 mm (95% confidence interval [CI]: 0.84–1.11) in the five-strand configuration compared with the traditional four-strand configuration (mean: 7.8 mm). There was no significant difference in the average increase in graft diameter between males (1.04 mm) and females (0.92 mm) (p = 0.323). Eighty-three percent (95% CI: 57.8–95.6) of average graft diameters ≤ 8 mm in the four-strand configuration achieved an average graft diameter of >8 mm in the five-strand configuration, and 70% (95% CI: 35.4– 91.9) of four-strand configuration average diameters < 8 mm achieved an average graft diameter > 8.0 mm in the five-strand configuration. Five-strand hamstring autograft reliably increased intraoperative hamstring tendon autograft diameter, with an average of 1 mm, compared with traditional four-strand configuration. This increase in diameter is independent of sex and remained significant when controlling for age, laterality, body mass index, and semitendinosus length.

scholarly journals Strength and Functional Outcomes Following Achilles Tendon Reconstruction Using Hamstring Tendon Autograft

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0017
Author(s):  
Taylor Cabe ◽  
Andrea Papson ◽  
Sydney Karnovsky ◽  
Jonathan Deland ◽  
Mark Drakos
Keyword(s):  
Achilles Tendon ◽  
Functional Outcomes ◽  
Hamstring Tendon ◽  
Positive Outcomes ◽  
Foot And Ankle ◽  
Hamstring Autograft ◽  
Tendon Reconstruction ◽  
Significant Difference ◽  
Achilles Tendon Reconstruction ◽  
Harvest Site

Category: Ankle Introduction/Purpose: Use of hamstring tendon (gracilis and/or semitendinosus) autografts with limited morbidity and positive outcomes has been well reported in knee ligament reconstructions as well as in foot and ankle applications including chronic Achilles rupture or Achilles tendinosis augmentations. Advantages of hamstring autograft reconstruction when compared to alternative procedures such as local tendon transfers, synthetic grafts, or allografts are better healing and reduced morbidity within the foot and ankle. In this study, we examined the effect of Achilles tendon reconstruction using hamstring autografts on strength and functional outcomes. We hypothesized patients would experience positive outcomes following repair evidenced by significant outcome score improvements and limited ankle plantarflexor and knee flexor strength deficits when compared to patients’ contralateral side and dorsiflexion and extension strength respectively. Methods: Patients who underwent Achilles repair with a hamstring autograft by a fellowship-trained sports medicine and foot and ankle surgeon since 2011 were evaluated for inclusion. Patients younger than 18 or with history of contralateral lower extremity pathology were excluded. Thirty-one potential participants were identified. Patients, average age 38 ± 10.9, had strength testing at an average of 19 months post-operatively (range 15-28 months). Isokinetic testing was completed with a Biodex dynamometer under supervision of a physical therapist blinded to surgical side. Peak plantarflexion and dorsiflexion torque and toque at 30 degrees of plantarflexion were measured at speeds of 60 and 120 degrees/sec. Peak flexion and extension torque and torque at 30, 70, and 90 degrees of flexion were measured at speeds of 180 and 300 degrees/sec. Pre- and post-operative FAOS scores were reviewed retrospectively. Comparisons were completed using Student’s T-tests. Results: All patients except one have reported being very satisfied or satisfied with their surgery. The remaining patient reported being neither satisfied nor dissatisfied. One case reported pain at the harvest site. No additional surgeries were required and all patients would recommend their surgery to someone else. The only significant difference (p<0.05) in relative plantarflexion and dorsiflexion strength within the ankle occurred at 30 degrees of plantarflexion when testing at the higher speed. Flexion strength was significantly lower (p<0.05) than extension strength at 90 degrees of flexion for both tested speeds and in peak torque at the higher speed (Table). Every FAOS subscale except Symptoms was significantly greater post-operatively than pre-operatively (p<0.05). Post-operative Symptoms scores were still greater by an average of 16.15 points with p=0.06. Conclusion: Achilles reconstruction using hamstring tendon autografts appears to produce good outcomes with minimal functional deficits. Functional outcome scores increase, patient satisfaction is relatively high, and there are limited negative symptoms at the harvest site. A greater than 10-point average difference between pre- and post-operative FAOS scores in each subscale reflects a clinically significant difference. Current data shows there is limited difference in loss of plantarflexion strength when compared to dorsiflexion. Similar to previous findings, hamstring strength is reduced at higher degrees of flexion and higher speeds. Overall, relative torque results reflect limited ankle or knee strength deficits.

Anterior-Cruciate-Ligament Reconstruction Using Doubled Hamstring-Tendon Autograft

2005 ◽  
Vol 14 (4) ◽  
pp. 279-293 ◽  
Author(s):  
Yoshiko Hasebe ◽  
Yoshie Tanabe ◽  
Kazunori Yasuda
Keyword(s):  
Anterior Cruciate Ligament ◽  
Muscle Strength ◽  
Acl Reconstruction ◽  
Performance Test ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Postoperative Recovery ◽  
Performance Tests ◽  
Hamstring Autograft ◽  
Anterior Cruciate

Context:Anterior cruciate ligament (ACL) reconstruction with doubled hamstring autograft might not sufficiently improve fundamental sports abilities of patients with ACL-deficient knees.Objective:To clarify whether ACL reconstruction using the hamstring graft can improve fundamental sports abilities.Design:Patients were examined twice, preoperatively and 2 years postoperatively, using the conventional evaluation scales and performance tests.Participants:15 athletic patients with ACL reconstruction using hamstring autograft.Measurements:A stairs-run test and figure-8 one-leg hop test. Muscle strength and knee stability were measured with Cybex® II and KT-2000® arthrometers, respectively.Results:There were no significant differences between the preoperative and postoperative results in the performance tests. The degree of postoperative recovery in the subjective score, the anterior translation of the tibia, and the isokinetic muscle strength was not significantly correlated with the degree of restoration in each performance test.Conclusions:Postoperative restoration as measured by conventional evaluation scales is not correlated with restoration of sports abilities in patients with ACL insufficiency.

scholarly journals A modified oblique incision in hamstring tendon graft harvesting during ACL reconstruction

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Biao Zhu ◽  
Xuelei Li ◽  
Tengteng Lou
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Sensory Loss ◽  
Functional Score ◽  
Hamstring Tendons ◽  
Prick Test ◽  
Significant Difference ◽  
Oblique Incision

Abstract Background During anterior cruciate ligament (ACL) reconstruction, different methods of harvesting hamstring tendon may lead to different degrees of injury to the inferior patellar branch of the saphenous nerve (IPBSN). Most of recent studies in the literature suggest that the classic oblique incision (COI) can reduce the incidence of IPBSN injury. We proposed a modified oblique incision (MOI) and compared it with the COI in terms of the resulting levels of injury and sensory loss and the clinical outcome. Methods Patients with ACL injury admitted to our hospital from April 2015 to July 2019 were randomly selected and included in our study. Thirty patients underwent the COI to harvest hamstring tendons, and the other 32 patients underwent the MOI. The pin prick test was performed to detect the sensation loss at 2 weeks, 6 months, and 1 year after the operation. Digital photos of the region of hypoesthesia area were taken, and then, a computer software (Adobe Photoshop CS6, 13.0.1) was used to calculate the area of the hypoesthesia. The length of the incision and knee joint functional score were also recorded. Results At the final follow-up, the incidence of IPBSN injury in COI and MOI were 33.3% and 9.4%, and the areas of paresthesia were 26.4±2.4 cm2 and 9.8±3.4 cm2 respectively. There was no significant difference in the incision length or knee functional score between the two groups. Conclusion The MOI can significantly reduce the risk of injury to the IPBSN, reduce the area of hypoesthesia, and lead to high subjective satisfaction. Therefore, compared with the COI, the MOI is a better method of harvesting hamstring tendons in ACL reconstruction.

İŞE BAĞLILIĞIN TÜKENMİŞLİK VE DEPRESYON DÜZEYLERİ ÜZERİNDEKİ ETKİLERİ: SAĞLIK ÇALIŞANLARI ÜZERİNDE BİR ARAŞTIRMA

2014 ◽  
Vol 1 (2) ◽  
pp. 206
Author(s):  
Haluk TANRIVERDİ ◽  
Mucize SARIHAN
Keyword(s):  
Regression Analysis ◽  
Correlation Analysis ◽  
Health Workers ◽  
Personal Information ◽  
Depression Scale ◽  
Work Commitment ◽  
Statistical Software ◽  
Research Hospital ◽  
Training And Research

The main purpose of this study is to examine the effects of health workers’ levels of work commitment on the levels of depression and burnout.  Having this purpose in mind, a questionnaire consisting of personal information form, work commitment scale, burnout scale and depression scale was conducted with 266 health workers of İstanbul Kartal Training and Research Hospital in May 2013. Data obtained from questionnaires were analyzed by SPSS 17,0 statistical software. Correlation analysis was utilized in order to determine the relationships among work commitment, burnout and depression levels of health workers whereas regression analysis was utilized in order to determine the effects of health workers’ levels of work commitment on the levels of depression and burnout. According to the results, it has been found that there are statistically relevant relationships among work commitment, burnout and depression levels of health workers. It has been concluded that the more health workers’ levels of work commitment increase, their levels of depression and burnout decrease.

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