Author/Authors :
Bernades aLBertoni, Leonardo José Knee Surgery and Arthroscopy Group - Universidade Federal de São Paulo (UNIFESP-EPM), São Paulo, SP. Brazil , deBieux, Pedro Knee Surgery and Arthroscopy Group - Universidade Federal de São Paulo (UNIFESP-EPM), São Paulo, SP. Brazil , eduardo da siLveira FranCiozi, CarLos Knee Surgery and Arthroscopy Group - Universidade Federal de São Paulo (UNIFESP-EPM), São Paulo, SP. Brazil , novaretti, João viCtor Sports Traumatology Group - Universidade Federal de São Paulo (UNIFESP-EPM), São Paulo, SP, Brazil , serGio de MeLo Granata Jr, GeraLdo Knee Surgery and Arthroscopy Group - Universidade Federal de São Paulo (UNIFESP-EPM), São Paulo, SP. Brazil , MaLheiros Luzo, MarCus viniCius Knee Surgery and Arthroscopy Group - Universidade Federal de São Paulo (UNIFESP-EPM), São Paulo, SP. Brazil
Abstract :
Objectives: To evaluate the regenerative capacity of gracilis (G)
and semitendinosus (ST) tendons, to examine the sensitivity and
specificity of signs and symptoms in the assessment of hamstring
tendons, and to assess the thickness and insertion site of regener-
ated tendons. Methods: Thirty sequential knees were subjected to
anterior cruciate ligament reconstruction with semitendinosus and
gracilis tendons. After surgery, the patients were followed up clini-
cally with physical examination and magnetic resonance imaging
(MRI). Results: Overall, 36.66% of the tendons were visible on MRI,
whereas 83.33% were palpable. On MRI, the distal insertion site of
the regenerated semitendinosus tendon was visible proximal to the
landmark of the medial femoral condyle in 28%, at the same level in
16%, and distally in 56% of the cases. Gracilis tendon insertion was
visible proximally in 36.66% of cases, at the same level in 10%, and
distally in 53.33%. Eleven knees exhibited complete regeneration.
Conclusion: Partial or total regeneration of the ST and G tendons was
apparent on MRI. Palpation is effective for evaluating regeneration
of the ST and G tendons; however, MRI is still the gold standard. ST
and G tendons regenerated completely in only a small percentage of
patients, limiting reuse as a graft in cases with new ligament injuries
of the knee. Level of Evidence II, Prospective comparative stud
Keywords :
Knee , Tendons , Magnetic Resonance Imaging , Physical Examination