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.
Tohyama
H
H
Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
Beynnon
B D
BD
Johnson
R J
RJ
Nichols
C E
CE
Renström
P A
PA
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*