Ultrasound-Guided Percutaneous Biopsies of the Semitendinosus Muscle following ACL Reconstruction - A Methodological Description

Abstract

Purpose: To evaluate whether the ultrasound-guided biopsy technique could be used to analyse the histochemical profile of m. semitendinosus following ACL reconstruction with autologous semitendinosus tendon graft. Material and Methods: Sixteen patients were included in the study. During ACL surgery, specimens from m. semitendinosus were obtained via open biopsy. Ultrasound-guided biopsies from m. semitendinosus were performed 7 - 11 months postoperatively from operated leg (n = 16) and non-operated leg (n = 8). Results: Two biopsy samples were pooled and formed a specimen of approximately 150 fibres. For fibre type composition, there was correlation between open biopsy and ultrasound-guided biopsy data, (P = 0.003, r = 0.89). The r-value for mean fibre area was 0.72 (P = 0.06). The methodological error for fibre type 1 % and mean fibre area was 9 %. Postoperatively, no significant differences were found in fibre type composition or fibre type areas between the operated and non-operated leg. Conclusion: Ultrasound-guided biopsy is an easy and safe technique that can be used for scientific studies and in clinical practice where biopsy from small muscles or from special location in muscles, such as in ruptures, scars or others is needed.

Key words

Ultrasound-guided biopsy - percutaneous needle biopsy - semitendinosus muscle - anterior cruciate ligament (ACL) - fibre type and fibre areas

References

• 1 Bergström J. Muscle electrolytes in man.  Scand J Clin Lab Invest. 1962;  14 p1-110
• 2 Blomstrand E, Ekblom B. The needle biopsy technique for fibre type determination in human skeletal muscle. A methodological study.  Acta Physiol Scand. 1982;  116 437-442
• 3 Dietrichson P, Mellgren S I, Skre H. Muscle biopsy with the percutaneous conchotome technique.  J Oslo City Hosp. 1980;  30 73-79
• 4 Edwards R HT, Young A, Wiles M. Needle biopsy of skeletal muscle in the diagnosis of myopathy and the clinical study of muscle function and repair.  N Engl J Med. 1980;  302 261-271
• 5 Eriksson K, Hamberg P, Jansson E, Larsson H, Shalabi A, Wredmark T. Semitendinosus Muscle in ACL Surgery: Morphology and Function. Proceedings of the ESSKA Congress. London, UK; 2000: 49
• 6 Esbjörnsson M, Jansson E, Sundberg C J, Sylve’n C, Eiken O, Nygren A, Kaijser L. Muscle fibre types and enzymes activities after training with local leg ischaemia in man.  Acta Physiol Scand. 1993;  148 233-241
• 7 Henriksson K G. “Semi-open” muscle biopsy technique. A simple outpatient procedure.  Acta Neurol Scand. 1979;  59 317-323
• 8 Jansson E. Methodology and actual perspectives of the evaluation of muscular enzymes in skeletal muscle by biopsy during rest, exercise and detraining.  Estratto da Medicina Dello Sport. 1994;  47 377-383
• 9 Lindequist S, Larsen C, Schröder H D. Ultrasound guided needle biopsy of skeletal muscle in neuromuscular disease.  Acta Radio Scand. 1990;  31 411-413
• 10 Movin T, Guntner P, Gad A, Rolf C. Ultrasonography-guided percutaneous core biopsy in Achilles tendon disorder.  Scandinavian Journal of Medicine & Science in Sports. 1997;  7 244-248
• 11 Movin T, Kristoffersen-Wiberg M, Shalabi A, Gad A, Aspelin P, Rolf C. Intratendinous alterations as imaged by ultrasound and contrast medium-enhanced magnetic resonance in chronic achillodynia.  Foot Ankle Int. 1998;  198-211
• 12 Nicholes B L, Hazlewood C F, Barnes D J. Percutaneous needle biopsy of quadriceps muscle: Potassium analysis in normal children.  J Pediatr. 1968;  72 840-852