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Magnetic Resonance Imaging Evaluation of the Integration and Maturation of Semitendinosus-Gracilis Graft in Anterior Cruciate Ligament Reconstruction Using Autologous Platelet Concentrate

ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY (2010)

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ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY

卷 26, 期 10, 页码 1318-1325

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W B SAUNDERS CO-ELSEVIER INC

DOI: 10.1016/j.arthro.2010.02.010

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Orthopedics Sport Sciences Surgery

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Purpose: To evaluate integration and maturation of semitendinosus-gracilis (STG) grafts in anterior cruciate ligament (ACL) reconstruction with magnetic resonance imaging (MRI) in patients who underwent ACL reconstruction with STG with and without autologous platelet concentrate (APC). Methods: A randomized single-blinded evaluator prospective study was performed in 2 consecutive series of patients who underwent reconstruction over a 14-month period: 30 with APC use (group A) and 20 as control subjects (group B). At 6 months, an MRI evaluation was performed, with observation of the graft's maturation and presence or absence of synovial fluid at the tunnel-graft interface. To facilitate interpretation, a scoring scale was designed to evaluate graft integration and maturation. Results: Regarding the presence of synovial fluid at the bone-graft interface, the test was negative in 86.84% of patients in group A and 94.74% in group B. A disorganized autograft signal pattern was found in 2.63% in group A and 5.26% in group B. Signal intensity was considered hypointense in 63.16% in group A and 42.11% in group B, isointense in 34.21% in group A and 52.63% in group B, and hyperintense in 0% in both groups. The final mean score was 4.45 points in group A and 4.2 points in group B (P >= .05). Poor integration was found in 2.63% in group A and 5.26% in group B (P = .214). Good integration was found in 97.37% in group A and 94.74% in group B (P = .784). Conclusions: In our consecutive series of patients who underwent ACL reconstruction with STG grafts, 1 group with intraoperative APC use versus a control group, followed up by MRI at 6 months after reconstruction, we did not find any statistically significant benefit in the APC group in terms of integration assessment and graft maturation (ligamentization). Level of Evidence: Level III, case-control study.

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Anterior Cruciate Ligament Reconstruction Using a 4-Strand Semitendinosus Tendon Graft or a Doubled Semitendinosus and Gracilis Tendon Graft: A 4.5-Year Prospective, Randomized, Double-Blind, Parallel-Group Study

Krzysztof Kulinski, Marcin K. Wasko, Ewa Trams, Kamila Malesa, Stanislaw Pomianowski, Rafal Kaminski

Summary: This study compared the effects of quadrupled semitendinosus tendon (ST) and doubled semitendinosus tendon and gracilis tendon (ST/G) grafts on patients undergoing anterior cruciate ligament reconstruction (ACLR) over a 4.5-year period. The results showed that female patients who underwent ACLR with a quadrupled ST graft had significantly increased anterior tibial translation, inferior functional results, and higher pain scores. However, in male patients, using either graft option for ACLR showed comparable results with no significant impact on donor site morbidity.

AMERICAN JOURNAL OF SPORTS MEDICINE (2023)