Abstract
BackgroundThe looped side of the semitendinosus tendon (ST) graft (i.e., the side inserted into the femoral tunnel during anterior cruciate ligament reconstruction) appears to be oval rather than round. The purpose of this study was to investigate the cross section of the fourfold semitendinosus tendon graft and, more specifically, the differences in pressure exerted by a rounded rectangular tunnel versus a round femoral tunnel.MethodsSeven STs were harvested from cadaveric knees and a fourfold ST graft was made. Aluminum cubes with round or rectangular tunnels containing four-way pressure-sensitive conductive sensors (vertically and bilaterally) were used. The area of both cubes was the same. The graft was inserted into the tunnels 15 mm from the looped edge. After measuring pressure, the graft was fixed using ultraviolet-curing acrylic resin and was cut at 7.5 mm and 15 mm from the lapel edge. The area, axes for the best fitting ellipse of the cross-section, and ellipticity of the axes were measured.ResultsIn the round tunnel, the mean contact pressure was 287.0 ± 136.7 gf at the bilateral sensor; there was no contact pressure detected by the vertical sensor. In the rounded rectangular tunnel, the mean contact pressure was 260.9 ± 186.4 gf at the bilateral sensor and 352.9 ± 49.5 gf at the vertical sensor. Ellipticity was 1.25 ± 0.13 at 7.5 mm, and 1.17 ± 0.07 at 15 mm from the lapel edge of the graft.ConclusionsThe cross-sectional shape of the fourfold ST graft was not round, but oval. Moreover, the rounded rectangular tunnel was more fitted to the graft than the round tunnel.
Highlights
The looped side of the semitendinosus tendon (ST) graft appears to be oval rather than round
We have realized that the looped side of the fourfold semitendinosus tendon graft—the side that is inserted into the femoral tunnel—appears to be oval or a rounded rectangle, rather than round
In the round tunnel, the mean contact pressure was 287.0 ± 136.7 gf at the bilateral sensor; no contact pressure was detected by the vertical sensor
Summary
The looped side of the semitendinosus tendon (ST) graft (i.e., the side inserted into the femoral tunnel during anterior cruciate ligament reconstruction) appears to be oval rather than round. Several studies have reported that the anatomical double-bundle technique provides more stable anterior– posterior translation and restores more rotational stability as compared with conventional single-bundle ACL reconstruction (Aglietti et al 2010; Colombet et al 2007; Yagi et al 2007). Several recent biomechanical studies have shown that single-bundle ACL grafts placed in the center of their anatomic insertions can restore nearly normal knee kinematics, which is comparable to results achieved with double-bundle ACL reconstruction (Ho et al 2009; Sastre et al 2010). Harms et al showed that single-graft ACL reconstruction performed at the central femoral and tibial ACL attachment sites can restore anterior-posterior translation and tibial rotation motion limits. The purpose of this study was to investigate the cross section of the fourfold semitendinosus tendon graft and, the differences in pressure exerted by a rounded rectangular tunnel versus a round femoral tunnel
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