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Cross-sectional area of hamstring tendon autograft after anatomic triple-bundle ACL reconstruction

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose was to evaluate the cross-sectional area changes in hamstring tendon autografts up to 5 years after the anatomic triple-bundle anterior cruciate ligament (ACL) reconstruction.

Methods

A total of 178 MRI scans from 139 patients (35 males, 104 females, mean age 30.4 years) with the anatomic triple-bundle ACL reconstructions were obtained to evaluate the cross-sectional area of the ACL grafts. They were classified into seven groups according to the period from reconstruction to MRI evaluation: Group2 months (m.), Group 36 m., Group 712 m, Group 12 years (y.), Group 23 y., Group 34 y., and Group 4 y.–. Intra-operatively, the cross-sectional area of the graft was measured directly using a custom-made area micrometre. Post-operatively, the cross-sectional area of the grafts’ mid-substance was measured with oblique axial MRI slices perpendicular to the long axis of the grafts using a digital radiology viewing program. The percent increase in the cross-sectional area was calculated by dividing the post-operative cross-sectional area by the intra-operative cross-sectional area.

Results

The mean percent increase in the cross-sectional area in Groups2 m., 36 m., 712 m., 12 y., 23 y., 34 y., and 4 y.– was 105.7 ± 14.0, 134.9 ± 20.0, 137.3 ± 27.8, 129.4 ± 22.2, 124.1 ± 20.4, 117.8 ± 16.9, and 117.1 ± 17.2 %, respectively. The percent increase in Groups 36 m., 712 m., and 12 y. was significantly greater than in Group2 m., while that in Group 4 y.– was significantly less than in Group 712 m.

Conclusions

The cross-sectional area of the hamstring tendon autografts after the anatomic triple-bundle ACL reconstruction increases over time up to 1 year post-operatively, decreases gradually thereafter, and reaches plateau at around 3 years.

Level of evidence

Retrospective case series, Level IV.

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Acknowledgments

The authors gratefully acknowledge Mr. Masahito Ishihara and Mr. Yukihiro Taue for MRI technical support, and Ms. Mari Maekawa for editorial assistance.

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Correspondence to Masayuki Hamada.

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Kinugasa, K., Hamada, M., Yoneda, K. et al. Cross-sectional area of hamstring tendon autograft after anatomic triple-bundle ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 25, 1219–1226 (2017). https://doi.org/10.1007/s00167-015-3880-5

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