Tendon regeneration and muscle hypotrophy after isolated Gracilis tendon harvesting - a pilot study
Abstract Purpose The gracilis tendon (GT) is a commonly used autologous graft in Orthopaedic surgery. The majority of information on knee function and outcomes after hamstring harvest is related to both semitendinosus and GT harvest. Little is known regarding isolated harvest of a GT. It was hypothe...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-04-01
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| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40634-020-00236-8 |
| _version_ | 1797331767328243712 |
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| author | Anne Flies Timm Denecke Natascha Kraus Philipp Kruppa Matthew T. Provencher Roland Becker Sebastian Kopf |
| author_facet | Anne Flies Timm Denecke Natascha Kraus Philipp Kruppa Matthew T. Provencher Roland Becker Sebastian Kopf |
| author_sort | Anne Flies |
| collection | DOAJ |
| description | Abstract Purpose The gracilis tendon (GT) is a commonly used autologous graft in Orthopaedic surgery. The majority of information on knee function and outcomes after hamstring harvest is related to both semitendinosus and GT harvest. Little is known regarding isolated harvest of a GT. It was hypothesized that isolated GT harvest would lead to altered gait patterns (e.g. augmented anterior-posterior translation or rotation in the tibiofemoral joint) and consequently a higher prevalence of cartilage lesions and meniscal tears in knees. Methods GT harvesting was performed on patients with chronic acromioclavicular joint instability without previous knee injuries or surgeries. MRI of both knees and thighs were performed. Knee MRI were evaluated using the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Inter- and intraobserver reliabilities, cross-sectional areas of different muscles, fatty infiltration of the gracilis muscle (GM) and GT regeneration were evaluated. The contralateral limb served as reference. The observers were blinded towards the identity of the patients and the operatively treated side. Results After a mean time of 44 months after surgery testing was performed on 12 patients. No significant side-to-side differences were found using WORMS, although there was a trend towards increased cartilage lesions after GT harvest (median healthy knee 4.8 and GT harvested knee 7.8 p = 0.086). Inter- and intraobserver repeatability was high with 0.899 (95% confidence interval (CI) 0.708–0.960) and 0.988 (95% CI 0.973–0.995), respectively. A significant hypotrophy of the GM with a mean decrease of 25.3%, 18.4% and 16.9% occurred at 25% (p = 0.016), 50% (p = 0.007) and 75% (p = 0.002) of the length of the femur from distal. No compensatory hypertrophy of other thigh muscles or increased fatty infiltration of the GM was found. Tendon regeneration took place in eight out of 12 patients. In case of regeneration, the regenerated tendon inserted in a more proximal place. Conclusion Isolated harvest of the GT for shoulder procedures did not affect knee MRI significantly indicating therefore in general suitable graft utilization for surgeries outside of the knee. GT regenerated in most patients with just a more proximal insertion and a hypotrophy of the muscle belly. |
| first_indexed | 2024-03-08T07:39:43Z |
| format | Article |
| id | doaj.art-07c4ca9b9ddc452e95d0833f27c18616 |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-03-08T07:39:43Z |
| publishDate | 2020-04-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-07c4ca9b9ddc452e95d0833f27c186162024-02-02T17:33:46ZengSpringerOpenJournal of Experimental Orthopaedics2197-11532020-04-01711910.1186/s40634-020-00236-8Tendon regeneration and muscle hypotrophy after isolated Gracilis tendon harvesting - a pilot studyAnne Flies0Timm Denecke1Natascha Kraus2Philipp Kruppa3Matthew T. Provencher4Roland Becker5Sebastian Kopf6Center for Musculoskeletal Surgery, Charité – University Medicine BerlinDepartment of Radiology, Charité – University Medicine BerlinClinic and Outpatient Clinic for Orthopaedics and Orthopaedic Surgery, University MedicineDepartment of Plastic, Aesthetic and Reconstructive Microsurgery/Hand surgery, Hospital Ernst von BergmannThe Steadman ClinicCenter of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Hospital Brandenburg an der HavelCenter of Orthopaedics and Traumatology, Brandenburg Medical School Theodor Fontane, Hospital Brandenburg an der HavelAbstract Purpose The gracilis tendon (GT) is a commonly used autologous graft in Orthopaedic surgery. The majority of information on knee function and outcomes after hamstring harvest is related to both semitendinosus and GT harvest. Little is known regarding isolated harvest of a GT. It was hypothesized that isolated GT harvest would lead to altered gait patterns (e.g. augmented anterior-posterior translation or rotation in the tibiofemoral joint) and consequently a higher prevalence of cartilage lesions and meniscal tears in knees. Methods GT harvesting was performed on patients with chronic acromioclavicular joint instability without previous knee injuries or surgeries. MRI of both knees and thighs were performed. Knee MRI were evaluated using the Whole-Organ Magnetic Resonance Imaging Score (WORMS). Inter- and intraobserver reliabilities, cross-sectional areas of different muscles, fatty infiltration of the gracilis muscle (GM) and GT regeneration were evaluated. The contralateral limb served as reference. The observers were blinded towards the identity of the patients and the operatively treated side. Results After a mean time of 44 months after surgery testing was performed on 12 patients. No significant side-to-side differences were found using WORMS, although there was a trend towards increased cartilage lesions after GT harvest (median healthy knee 4.8 and GT harvested knee 7.8 p = 0.086). Inter- and intraobserver repeatability was high with 0.899 (95% confidence interval (CI) 0.708–0.960) and 0.988 (95% CI 0.973–0.995), respectively. A significant hypotrophy of the GM with a mean decrease of 25.3%, 18.4% and 16.9% occurred at 25% (p = 0.016), 50% (p = 0.007) and 75% (p = 0.002) of the length of the femur from distal. No compensatory hypertrophy of other thigh muscles or increased fatty infiltration of the GM was found. Tendon regeneration took place in eight out of 12 patients. In case of regeneration, the regenerated tendon inserted in a more proximal place. Conclusion Isolated harvest of the GT for shoulder procedures did not affect knee MRI significantly indicating therefore in general suitable graft utilization for surgeries outside of the knee. GT regenerated in most patients with just a more proximal insertion and a hypotrophy of the muscle belly.http://link.springer.com/article/10.1186/s40634-020-00236-8GracilisAutograftTendon harvestMRIRadiologic outcome |
| spellingShingle | Anne Flies Timm Denecke Natascha Kraus Philipp Kruppa Matthew T. Provencher Roland Becker Sebastian Kopf Tendon regeneration and muscle hypotrophy after isolated Gracilis tendon harvesting - a pilot study Journal of Experimental Orthopaedics Gracilis Autograft Tendon harvest MRI Radiologic outcome |
| title | Tendon regeneration and muscle hypotrophy after isolated Gracilis tendon harvesting - a pilot study |
| title_full | Tendon regeneration and muscle hypotrophy after isolated Gracilis tendon harvesting - a pilot study |
| title_fullStr | Tendon regeneration and muscle hypotrophy after isolated Gracilis tendon harvesting - a pilot study |
| title_full_unstemmed | Tendon regeneration and muscle hypotrophy after isolated Gracilis tendon harvesting - a pilot study |
| title_short | Tendon regeneration and muscle hypotrophy after isolated Gracilis tendon harvesting - a pilot study |
| title_sort | tendon regeneration and muscle hypotrophy after isolated gracilis tendon harvesting a pilot study |
| topic | Gracilis Autograft Tendon harvest MRI Radiologic outcome |
| url | http://link.springer.com/article/10.1186/s40634-020-00236-8 |
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