Abstract
BackgroundThe gracilis tendon is commonly used as an autograft to reconstruct torn tendons or ligaments in many parts of the body. Little is known about the subjective and functional outcome after gracilis tendon harvest. The aim of this study was to evaluate the outcome of the donor leg in patients undergoing such surgery.MethodsPatients with chronic acromioclavicular joint dislocations undergoing coracoclavicular ligament reconstructions using autogenous gracilis tendon grafts were eligible for this study. The graft harvesting procedure was carried out in a standard fashion using a tendon stripper. Knee injury and Osteoarthritis Outcome Score (KOOS) were collected preoperatively and after 12 months. The first 5 patients were included retrospectively and lacked preoperative data, for these patients age- and gender matched normative KOOS scores were used as baseline values. Isometric knee flexor strength in 60° and 90° degrees of flexion was measured at final follow up at a median of 26 (14–56) months postoperatively with the non-operated leg used as reference.ResultsTwenty four patients were eligible for the study and 2 were excluded. The 22 patients available for analysis had a mean age of 44 (22–62) years at the time of surgery and 4 were women. There was no statistically significant change in KOOS 12 months postoperatively compared to baseline values but the patients were weaker in knee flexion in the operated leg compared to the non-operated one.ConclusionsGracilis tendon harvesting results in a weakness of knee flexion but does not impair subjective knee function and is a procedure that can be recommended when an autogenous tendon graft is needed.
Highlights
The gracilis tendon is commonly used as an autograft to reconstruct torn tendons or ligaments in many parts of the body
Most commonly it is used in combination with the semitendinosus tendon as a hamstring graft in anterior cruciate ligament (ACL) reconstructions, but it is frequently used in other knee reconstructive procedures as well as in shoulder, elbow, hip and ankle surgery [1,2,3,4,5,6]
Two studies touching on this subject concern patients undergoing primary, unilateral ACL reconstructions that were randomized with regard to which leg the hamstring graft would be harvested
Summary
The gracilis tendon is commonly used as an autograft to reconstruct torn tendons or ligaments in many parts of the body. While graft site morbidity and knee flexor strength after ACL reconstruction using hamstring grafts has been thoroughly studied [10, 11], there is little evidence regarding the knee related outcome after isolated gracilis tendon harvesting from a limb in which no reconstructive procedure is planned. Nordin et al BMC Musculoskeletal Disorders (2019) 20:138 from [12, 13] Both of these trials report that graft harvesting is associated with a decrease in knee flexor strength that is resolved within 12 months postoperatively and they do not advice against using the unaffected leg as a graft donor site. The trials above studied the effect of harvesting a two-tendon hamstring autograft for use in ACL-reconstruction and these results cannot be directly translated to a situation where an isolated gracilis graft is used for reconstructive procedures in other parts of the body than the knee. The patients were significantly weaker in knee flexion in the donor leg compared to the contralateral one but displayed minimal donor site morbidity
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