The Effect of Gracilis Tendon Preservation on Postoperative Knee Joint Stability and Muscle Strength in Arthroscopic Anterior Cruciate Ligament Reconstruction Surgery

Mehmet Ekinci; Taha Bedir Demir; Turker Sahinkaya; Sertac Yakal; Gokhan Polat; Bulent Bayraktar

doi:10.1055/s-0044-1787829

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2024; 37(12): 843-850
DOI: 10.1055/s-0044-1787829

Original Article

The Effect of Gracilis Tendon Preservation on Postoperative Knee Joint Stability and Muscle Strength in Arthroscopic Anterior Cruciate Ligament Reconstruction Surgery

Authors

Mehmet Ekinci

¹Department of Orthopaedics and Traumatology, Haseki Education and Training Hospital, Istanbul, Turkey
Taha Bedir Demir

²Department of Orthopaedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Turker Sahinkaya

³Department of Sports Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Sertac Yakal

³Department of Sports Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Gokhan Polat

²Department of Orthopaedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
Bulent Bayraktar

³Department of Sports Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

Abstract

The aim of our study is to evaluate preserving gracilis tendon in anterior cruciate ligament reconstruction (ACLR) surgery and its effect to the flexion of the knee joint and tibial internal rotation strength and the stability of the knee. Patients who underwent primary single-bundle arthroscopic ACLR using all-inside technique and using hamstring tendon autograft were evaluated retrospectively. Patients were divided into two groups as gracilis preserved (St) and gracilis harvested (StG) groups. The International Knee Documentation Committee (IKDC) score, Lysholm, Knee Injury and Osteoarthritis Outcome Score—Knee-related quality of life (KOOS-QOL) score, ACL-Return to Sport after Injury scale score were used to evaluate as postoperative functional scores at last follow-up. Anterior tibial translation was evaluated using the KT-1000 device. Knee joint flexion, extension, and internal rotation strength were evaluated using isokinetic dynamometer. Dynamic balance performances were measured using the Biodex Balance System. There were 24 patients in the St group and 23 patients in the StG group. Demographic data and clinical results showed no significant difference. Anteroposterior movement of the tibia was found to be significantly higher in the StG group than in the St group in measurements at 89 and 134 N, respectively (p = 0.01 and <0.001). No statistically significant difference was found between both standard and deep flexor and extensor and internal rotator strength. No statistically significant difference was found in the amount of total, anteroposterior, and mediolateral balance deficit between the two groups. Additional gracilis harvesting does not have a negative effect on both standard and deep knee flexion, and tibial internal rotation strength compared with the St group. Although semitendinosus and StG group showed significantly more anterior tibial translation, there was no significant difference in clinical and dynamic stability measurements.

Keywords

anterior cruciate ligament reconstruction - semitendinosus - gracilis - single - semitendinosus - hamstring strength - tibial internal rotation strength - dynamic postural stability

Full Text

References

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