Anne Flies1, Markus Scheibel1, Natascha Kraus2, Philipp Kruppa3, Matthew T Provencher4, Roland Becker5, Sebastian Kopf6. 1. Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Berlin, Germany. 2. Clinic and Outpatient Clinic for Orthopaedics and Orthopaedic Surgery, University Medicine, Greifswald, Germany. 3. Department of Plastic, Aesthetic and Reconstructive Microsurgery/Hand Surgery, Hospital Ernst Von Bergmann, Potsdam, Germany. 4. The Steadman Clinic, Vail, CO, USA. 5. Center of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Hospital Brandenburg an der Havel, Hochstraße 29, 14770, Brandenburg an der Havel, Germany. 6. Center of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Hospital Brandenburg an der Havel, Hochstraße 29, 14770, Brandenburg an der Havel, Germany. s.kopf@klinikum-brandenburg.de.
Abstract
PURPOSE: The gracilis tendon is a commonly used autologous graft. Most information on knee function and outcomes after its harvest is related to both semitendinosus- and gracilis tendon harvest. Therefore this study analyzed the effect of isolated gracilis tendon harvest from healthy, uninjured knees on thigh muscle strength and patient reported outcome measures (PROMs). METHODS: Stabilization of the acromioclavicular joint because of chronic instability was performed with autologous gracilis tendon in 12 patients. After a mean of 44 ± 25 months after surgery, isokinetic peak-torque measurements of specific functions of the gracilis muscle were performed: knee flexion in a sitting position (flexion angles 0-90°) and in prone position (flexion angles > 70°), internal tibial rotation and hip adduction. The contralateral limb was control. Knee specific PROMs were collected including IKDC-2000 subjective evaluation form, Lysholm score, the Marx Activity Rating Scale and SF-36 health survey. RESULTS: No significant side-to-side differences were found regarding torque measurements. Excellent results were shown regarding the PROMs, which even in terms of IKDC-2000 (97 vs. 82 points, p = 0.001) exceeded significantly the age- and gender matched reference-data. CONCLUSION: Isolated gracilis tendon harvesting was not associated with loss of strength in knee flexion, internal tibial rotation and thigh adduction. Additionally, good functional outcome as well as excellent knee-specific subjective outcome was found. LEVEL OF EVIDENCE: III.
PURPOSE: The gracilis tendon is a commonly used autologous graft. Most information on knee function and outcomes after its harvest is related to both semitendinosus- and gracilis tendon harvest. Therefore this study analyzed the effect of isolated gracilis tendon harvest from healthy, uninjured knees on thigh muscle strength and patient reported outcome measures (PROMs). METHODS: Stabilization of the acromioclavicular joint because of chronic instability was performed with autologous gracilis tendon in 12 patients. After a mean of 44 ± 25 months after surgery, isokinetic peak-torque measurements of specific functions of the gracilis muscle were performed: knee flexion in a sitting position (flexion angles 0-90°) and in prone position (flexion angles > 70°), internal tibial rotation and hip adduction. The contralateral limb was control. Knee specific PROMs were collected including IKDC-2000 subjective evaluation form, Lysholm score, the Marx Activity Rating Scale and SF-36 health survey. RESULTS: No significant side-to-side differences were found regarding torque measurements. Excellent results were shown regarding the PROMs, which even in terms of IKDC-2000 (97 vs. 82 points, p = 0.001) exceeded significantly the age- and gender matched reference-data. CONCLUSION: Isolated gracilis tendon harvesting was not associated with loss of strength in knee flexion, internal tibial rotation and thigh adduction. Additionally, good functional outcome as well as excellent knee-specific subjective outcome was found. LEVEL OF EVIDENCE: III.
Authors: Jason M Konrath; Christopher J Vertullo; Ben A Kennedy; Hamish S Bush; Rod S Barrett; David G Lloyd Journal: Am J Sports Med Date: 2016-07-18 Impact factor: 6.202
Authors: James J Irrgang; Allen F Anderson; Arthur L Boland; Christopher D Harner; Philippe Neyret; John C Richmond; K Donald Shelbourne Journal: Am J Sports Med Date: 2006-07-26 Impact factor: 6.202