Journal of experimental orthopaedics · 2025
Similar results with quadrupled semitendinosus and semitendinosus-gracilis graft in anterior cruciate ligament reconstruction: A randomised controlled trial with 2-year follow-up.
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Martinez-Cano Juan P, Gallego Alejandro, Cuadros Janio, Ibarra Laura, Mejía Fernando M, Velasquez-Hammerle María V, Martinez-Rondanelli Alfredo
Аннотация
PURPOSE: to compare quadrupled semitendinosus (STx4) with semitendinosus-gracilis graft in anterior cruciate ligament (ACL) reconstruction surgery.
METHODS: Parallel randomised controlled trial with two groups of treatment (n = 42) in primary ACL reconstruction surgery. Follow-up during 2 years after surgery with visits at 3, 6, 12 and 24 months. Primary outcome: quadriceps and hamstrings strength in newtons (N). Secondary outcomes: ACL re-rupture, additional surgeries, return to sport and patient-reported outcomes (PROMs): knee injury and osteoarthritis outcome score (KOOS), International Knee Documentation Committee (IKDC) and Tegner-Lysholm.
RESULTS: There was 1/21 ACL re-rupture for STx4 and 2/21 for the control group (p = 0.9). One additional surgery for each group: ACL revision (control group) and meniscectomy (STx4). There were no other complications and no differences in PROMs between grafts, except for Tegner-Lysholm at 3 months, that favoured the STx4 group (76.0, confidence interval [CI]: 56.0-86.0 vs. 85.0, CI: 77.0-93.0), p = 0.04. The median surgery satisfaction was good in both groups STx4 (95%, interquartile range (IQR): 90%-98%) and ST-G (98%, IQR: 95%-100%) (p = 0.13). Return to sport was 90% (n = 19) for the STx4 group and 81% (n = 17) for the ST-G group (p = 0.37). Quadriceps strength recovered sooner (6 months) than hamstrings (24 months) in both groups. There were no statistically significant differences in strength between STx4 and ST-G at final follow-up (hamstrings in flexion [mean ± SD]: 173 ± 53 N vs. 166 ± 51 N, p = 0.7; hamstrings in extension: 204 ± 61 N vs. 199 ± 64 N, p = 0.8; quadriceps in flexion: 217 ± 42 N vs. 209 ± 47 N, p = 0.6; quadriceps in extension: 193 ± 51 N vs. 191 ± 46 N, p = 0.9).
CONCLUSIONS: This study found no statistically significant differences at 2 years between a STx4 and a ST-G graft configuration for primary ACL reconstruction regarding strength, PROMs, return to sport, failure rates and complications; larger studies are required to confirm noninferiority. Clinical Trials number: NCT03433170.
LEVEL OF EVIDENCE: Level I.
METHODS: Parallel randomised controlled trial with two groups of treatment (n = 42) in primary ACL reconstruction surgery. Follow-up during 2 years after surgery with visits at 3, 6, 12 and 24 months. Primary outcome: quadriceps and hamstrings strength in newtons (N). Secondary outcomes: ACL re-rupture, additional surgeries, return to sport and patient-reported outcomes (PROMs): knee injury and osteoarthritis outcome score (KOOS), International Knee Documentation Committee (IKDC) and Tegner-Lysholm.
RESULTS: There was 1/21 ACL re-rupture for STx4 and 2/21 for the control group (p = 0.9). One additional surgery for each group: ACL revision (control group) and meniscectomy (STx4). There were no other complications and no differences in PROMs between grafts, except for Tegner-Lysholm at 3 months, that favoured the STx4 group (76.0, confidence interval [CI]: 56.0-86.0 vs. 85.0, CI: 77.0-93.0), p = 0.04. The median surgery satisfaction was good in both groups STx4 (95%, interquartile range (IQR): 90%-98%) and ST-G (98%, IQR: 95%-100%) (p = 0.13). Return to sport was 90% (n = 19) for the STx4 group and 81% (n = 17) for the ST-G group (p = 0.37). Quadriceps strength recovered sooner (6 months) than hamstrings (24 months) in both groups. There were no statistically significant differences in strength between STx4 and ST-G at final follow-up (hamstrings in flexion [mean ± SD]: 173 ± 53 N vs. 166 ± 51 N, p = 0.7; hamstrings in extension: 204 ± 61 N vs. 199 ± 64 N, p = 0.8; quadriceps in flexion: 217 ± 42 N vs. 209 ± 47 N, p = 0.6; quadriceps in extension: 193 ± 51 N vs. 191 ± 46 N, p = 0.9).
CONCLUSIONS: This study found no statistically significant differences at 2 years between a STx4 and a ST-G graft configuration for primary ACL reconstruction regarding strength, PROMs, return to sport, failure rates and complications; larger studies are required to confirm noninferiority. Clinical Trials number: NCT03433170.
LEVEL OF EVIDENCE: Level I.