Morphometry of the semitendinosus and gracilis tendons with application to anterior cruciate ligament reconstruction.
The length and cross-sectional area of human semitendinosus and gracilis tendons were measured in both single- and multi-strand configurations for the purpose of anterior cruciate ligament graft preparation. The average lengths of the semitendinosus and the gracilis tendons were 235 +/- 20 mm (mean +/- SD) and 200 +/- 17 mm, respectively. The cross-sectional area of a doubled semi-tendinosus tendon (two strands) was significantly less than that of a 10-mm-wide patellar tendon graft (P < 0.001). The cross-sectional area of the tripled semitendinosus tendon (three strands) and the 10-mm-wide patellar tendon were similar. Doubling of the combined semitendinosus and gracilis tendons (four strands) and tripling of this combination (six strands) resulted in a significantly greater cross-sectional area in comparison to the 10-mm-wide patellar tendon (P < 0.05, four strands; P < 0.001 six strands). This investigation demonstrates that anterior cruciate ligament grafts fashioned using multiple-strand combinations of the semitendinosus and gracilis tendons result in a cross-sectional area that is comparable to the bone-patellar tendon-bone graft. This is an important finding since cross-sectional area reflects the intra-articular volume of collagenous tissue. This information should be helpful to surgeons considering using the hamstring tendons as an anterior cruciate ligament graft.
Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
H
H
Tohyama
B D
BD
Beynnon
R J
RJ
Johnson
C E
CE
Nichols
P A
PA
Renström
D000368:Aged; D000704:Analysis of Variance; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D002102:Cadaver; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D013710:Tendons / Q000033:anatomy & histology* / Q000502:physiology / Q000637:transplantation*