The influence of thickness of ACL tendon graft on long-term results of treatment

Piotr Piech, Paweł Polak, Maciej Kozioł, Paweł Obierzyński, Grzegorz Staśkiewicz, Małgorzata Neścior


1. INTRODUCTION: Operative treatment is the treatment of choice for the most severe, third-degree ACL sprain. Many operational techniques exist, including technique using a quadruple-folded semitendinosus tendon and the technique of double-folded semitendinosus and gracilis tendons. Depending on the technique chosen, we can obtain different thicknesses of the grafts used.


2. AIM OF THE STUDY: To find a relationship between the type of surgical technique used and the thickness of the graft, as well as to assess the effect of the thickness of the applied autograft on the long-term outcome of the treatment.


3. MATERIALS AND METHODS: A retrospective study included a group of 43 patients operated on due to ACL injury. In 21 patients, the procedure was performed using the quadruple-folded semitendinosus tendon, whereas in 22 patients the procedure was performed using double-folded semitendinosus and gracilis tendons. The patients were divided into groups based on the thickness of the transplant. A special questionnaire prepared on the basis of the KOOS scale was used to assess the subjective performance of the knee. The type and thickness of the graft was determined based on the analysis of operational protocols. The statistical analysis of the results of the study was performed. The Chi-square compatibility test or chi-square compatibility test in the Yates modification were used to assess the relationship.


4. RESULTS: A relationship was found between the parameters: "general quality of life" (p = 0.01), "pain" (p = 0.005), "sports activity" (p = 0.05), "everyday activities" (p = 0, 01). There is no dependence for the "other symptoms" parameter (p = 0.1). There is no relationship between the technique used and the graft thickness (p = 0.2).


 5. CONCLUSIONS: The choice of the surgical technique does not affect the final thickness of the autograft. Overall quality of life, pain, sports activity; everyday activities are the parameters of the KOOS scale, which are affected by the thickness of the transplant.


ACL; anterior cruciate ligament; reconstruction; graft

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Butler DL: Anterior cruciate ligament: its normal response and replacement. J. Orthop. Res. 1989 7:910 – 921.

Johnson RJ, Beynnon BD, Nichols CE and Renstrom PAFH: Current concepts review. The treatment of injuries of the anterior cruciate ligament. J. Bone and Joint Surg. Jan. 1992 74-A: 140 – 151.

Feagin JA Jr. [editor]: The Crucial Ligaments: Diagnosis and Treatment of Ligamentous Injuries about the Knee. New York, Churchill Livingstone, 1988.

Daniel DM, Akeson WH and O’Connor JJ [editors]: Knee Ligaments: Structure, Function, Injury, and Repair. New York, Raven Press, 1990.

Piech P, Polak P, Kozioł M et al.: Comparision of treatment outcomes in isolated injuries of anterior cruciate ligament (ACL) and injuries of ACL connected with damages of menisci, conducted with use of KOOS scale. Journal of Education, Health and Sport 2017 vol. 7 nr 4, s. 29-37.

Piech P, Polak P, Rasoul K: The comparison between the results of treatment of patients after ACL reconstruction using double-folded semitendinosus and gracilis tendons and quadruple-folded semitendinosus tendon. Journal of Education, Health and Sport 2017 vol. 7 nr 6, s. 107-119.

Levy AS, Meier SW: Approach to cartilage injury in the Anterior cruciate ligament-deficient knee. Orthop Clin North Am. 2003;34:149-167.

Sharp JW, Kani KK, Gee A et al.: Anterior cruciate ligament fixation devices: Expected imaging appearance and common complications. Eur J Radiol. 2018 Feb;99:17-27.

Matava MJ: Complications of anterior cruciate ligament reconstruction: graft issues. Instr Course Lect, 2006; 55: 489–96.

Sekiya JK, Ong BC, Bradley JP: Complications in anterior cruciate ligament surgery. Orthop Clin North Am, 2003; 34(1): 99–105.

Sommerlath K: The importance of meniscus in unstable knee: a comparative study. Am Sports Med, 1989; 17: 173–77.

Wolf RS, Lemak LJ: Revision anterior cruciate ligament reconstruction surgery. J South Orthop Assoc, 2002; 11(1): 25–32.

Stolarczyk A, Nagraba Ł, Mitek T et al.: The comparison of two methods of arthroscopic anterior cruciate ligament reconstruction. Artroskopia i Chirurgia Stawów, 2006; 2(3): 22–29.

Stolarczyk A, Kalińska J, Nagbara Ł et AT al.: Management of anterior cruciate ligament injuries. Artroskopia i Chirurgia Stawów, 2007; 3(2): 18-29.

Mioduszewski A: The cruciate ligaments treatment strategy; Acta Clinica, 2002;2(1): 17-25.



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