2023 ISAKOS Biennial Congress ePoster
Quadrupled Semitendinosus vs. Semitendinosus-Gracilis Graft for ACL Reconstruction:a Randomized Controlled Trial
Juan Pablo Martinez-Cano, MD, MSc, PhD, Cali, Valle del Cauca COLOMBIA
Laura Zamudio, MD, Cali, Valle COLOMBIA
Julian Chica, MD, Cali, Valle COLOMBIA
Juan José Martinez Arboleda, MD, Cali, Valle COLOMBIA
Fernando M. Mejia, MD, Cali, Valle COLOMBIA
Alfredo Martinez Rondanelli, MD, Cali COLOMBIA
Fundación Valle del Lili, Cali, Valle, COLOMBIA
FDA Status Cleared
Summary
This study was not able to find differences between quadrupled semitendinosus or semitendinosus-gracilis autograft in ACL reconstruction in terms of strength, PROMs or failure.
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Abstract
Introduction
there are multiple techniques for anterior cruciate ligament (ACL) reconstruction. Hamstrings autograft are one of the most popular worldwide. Techniques with short grafts that use only the semitendinosus tendon in a quadrupled disposition have been described. Preserving the gracilis, may have the potential advantage of improving hamstrings strength.
Purpose
to compare the strength, failure and functional outcomes between quadrupled semitendinosus vs semitendinosus-gracilis graft after ACL reconstruction surgery.
Methods
42 patients with ACL tear, were randomized to traditional semitendinosus-gracilis autograft (control group) or quadrupled semitendinosus autograft (STx4) and were followed-up for 2 years. Outcomes were studied at baseline, 3, 6, 12 and 24 months: functional scores (KOOS, IKDC, Tegner-Lysholm), anterior knee laxity and strength (quadriceps and hamstrings). Re-tear was studied clinically and with MRI when needed.
Results
there were 2 ACL re-tears in the control group and 1 re-tear in the STx4 group (p=0.9). No statistically significant differences were found between groups for strength of quadriceps or hamstrings at any point. In PROMs, there was only difference at 3 months in Tegner-Lysholm score favoring the STx4 group (76 vs 86, p=0.04). Graft diameter was 8.9 mm for STx4 compared to 8.5 mm in the control group (p=0.28). Satisfaction with surgery at final follow-up was 98% (STx4) and 95% (control group), p=0.13.
Conclusion
ACL reconstruction with hamstrings autograft offers similar results in strength and functional scores between a traditional semitendinosus-gracilis graft or a quadrupled semitendinosus technique. Both techniques showed to be safe, improved PROMs, offered satisfaction and had low failure rate.