Research Article| Volume 8, ISSUE 1, P65-77, March 1992

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Arthroscopic-assisted anterior cruciate ligament reconstruction with the semitendinosus tendon: Comparison of results with and without braided polypropylene augmentation

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      Fifteen chronic anterior cruciate ligament-deficient knees were arthroscopically reconstructed with a semitendinosus tendon polypropylene (STP) augmented composite graft. A comparison group of 28 reconstructions with the semitendinosus tendon (ST) but without augmentation was simultaneously reviewed. The mean follow-up in the STP group was 31 months (range of 24–42 months) and in the ST group it was 34 months (range 26–54 months). Both patient groups had similar age, sex, preinjury functional sports level, injury-to-surgery interval, and associated meniscal pathology. Good-to-excellent subjective results were reported in 86% of STP patients and 78% of ST patients, whereas 86% of the STP patients and 88% of the ST patients returned to sports activity. Objective examination revealed 73% of the STP group and 82% of the ST group to have a negative or 1 + Lachman test result. A negative pivot shift was noted at follow-up in 80% of the STP group and in 82% of the ST group. KT-1000 testing revealed 60% of the STP patients and 61% of the ST patients to have ≤3 mm of side-to-side difference. In the STP group there was no evidence of graft breakage, deep infections, or sterile effusions. Overall subjective and functional results were uniformly better than objective results in both patient groups. Analysis of subjective, objective, and functional results reveal no difference in outcome between the STP and the ST patient groups.


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        • Noyes FR
        • Butler DL
        • Grood ES
        • Zernicke RF
        • Hefzy MS
        Biomechanical analysis of human ligament grafts used in knee ligament repairs and reconstructions.
        J Bone Joint Surg [Am]. 1984; 66: 344-352
        • Cho KO
        Reconstruction of the anterior cruciate ligament by semitendinosus tenodesis.
        J Bone Joint Surg [Am]. 1975; 57: 608
        • Gomes JLE
        • Marczyk LRS
        Anterior cruciate ligament reconstruction with a “loop” or double thickness of semitendinosus tendon.
        Am J Sports Med. 1984; 12: 199-203
        • Lipscomb AB
        • Johnston RK
        • Snyder RB
        The technique of cruciate ligament reconstruction.
        Am J Sports Med. 1981; 9: 77
        • Lipscomb AB
        • Johnston RK
        • Snyder RB
        • Brothers JC
        Secondary reconstruction of anterior cruciate ligament in athletes using the semitendinosus tendon.
        Am J Sports Med. 1979; 7: 81-84
        • Hanley ST
        • Warren RF
        Arthroscopic meniscectomy in the anterior cruciate ligament-deficient knee.
        Arthroscopy. 1987; 3: 59-65
        • Puddu G
        Method for Reconstruction of the anterior cruciate ligament using the semitendinosus tendon.
        Am J Sports Med. 1980; 8: 402
        • Sgaglione NA
        • Warren RF
        • Wickiewicz TL
        • Gold DA
        • Panariello RA
        Primary repair with semitendinosus tendon augmentation of acute anterior cruciate ligament injuries.
        Am J Sports Med. 1989; 18: 64-73
        • Zaricznyj B
        Reconstruction of the anterior cruciate ligament using free tendon graft.
        Am J Sports Med. 1983; 11: 164
        • Zaricznyj B
        Reconstruction of the anterior cruciate ligament of the knee using a doubled tendon graft.
        Clin Orthop. 1987; 220: 162-175
        • Kennedy JC
        • Roth JH
        • Mendenhall HV
        • Sanford JB
        Intraarticular replacement of the anterior cruciate ligament deficient knee.
        Am J Sports Med. 1980; 8: 1-8
        • Hanley P
        • Lew WD
        • Lewis JL
        • Hunter RE
        • Kirstukas S
        • Kowalczyk C
        Load sharing and graft forces in anterior cruciate ligament reconstructions with the ligament augmentation device.
        Am J Sports Med. 1989; 17: 414-422
        • Windsor RE
        • Insall JN
        • Warren RF
        • Wickiewicz TL
        The hospital for special surgery knee ligament rating form.
        Am J Knee Surg. 1988; 1: 140-145
        • Bach BR
        • Warren RF
        • Wickiewicz TL
        Observations on the effect of hip and foot position on the pivot shift phenomenon.
        Am J Sports Med. 1987; 15: 626
        • Beithon PH
        • Horan FT
        Dominant inheritance in familial generalized articular hypermobility.
        J Bone Joint Surg [Am]. 1970; 52: 145
        • Marshall JL
        • Fetto JF
        • Botero P
        Knee ligament injuries; a standardized evaluation method.
        Clin Orthop. 1977; 123: 115-129
        • Tegner Y
        • Lysholm J
        Rating systems in the evaluation of knee ligament injuries.
        Clin Orthop. 1985; 198: 43-49
        • Lysholm J
        • Gillquist J
        Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale.
        Am J Sports Med. 1982; 10: 150
        • Friedman MJ
        Arthroscopic semitendinosus (gracilis) reconstruction for anterior cruciate ligament deficiency.
        in: Dorr L Techniques in orthopedics. Aspen Publishers, Frederick, Maryland1988: 74-80
        • Lipscomb AB
        • Johnston RK
        • Snyder RB
        Evaluation of hamstring strength following use of semitendinosus and gracilis tendons to reconstruct the anterior cruciate ligament.
        Am J Sports Med. 1982; 10: 340
        • Mott HW
        Semitendinosus anatomic reconstruction for cruciate ligament insufficiency.
        Clin Orthop. 1983; 172: 90-92
        • Fowler PJ
        Techniques using braided polypropylene as a ligament augmentation device.
        Techniques Orthop. 1988; 2: 81-85
        • Fowler PJ
        A conversation with Peter J. Fowler, MD: Kennedy ligament augmentation device for supports of tissue graft in the cruciate deficient knee.
        Orthop Rev. 1985; 14: 17-25
        • Fowler PJ
        Technique for anterior cruciate ligament reconstruction: the Kennedy LAD.
        3M, St. Paul1987
        • Roth JH
        • Kennedy JC
        • Gomez-Castresana F
        The reconstruction of the anterior cruciate ligament reinforced with a polypropylene braid.
        in: AAOS Instructional Course Lectures, Proceedings of instructional course, Atlanta, Georgia1988
        • Roth JH
        • Kennedy JC
        • Lockstadt H
        • McCallum CL
        • Cunning LA
        Polypropylene braid augmented and nonaugmented intraarticular anterior cruciate ligament reconstruction.
        Am J Sports Med. 1985; 13: 321-336
        • Marshall JL
        • Warren RF
        • Wickiewicz TL
        Primary surgical treatment of ACL lesions.
        Am J Sports Med. 1982; 10: 103
        • Noyes FR
        • McGinniss GH
        Controversy about treatment of the knee with anterior cruciate laxity.
        Clin Orthop. 1985; 198: 61
        • Levy IM
        • Torzilli PA
        • Warren RF
        The effect of medial meniscectomy on the anterior-posterior motion of the knee.
        J Bone Joint Surg [Am]. 1982; 64: 883