hamstring

Anterior cruciate ligament is an intra-articular, extra synovial structure present in the central complex of the knee joint which along with other structures in the knee joint controls, limits motion and maintains static and dynamic equilibrium of knee joint. The knee joint is the most commonly injured of all joints and the anterior cruciate ligament is the most commonly injured ligament. The most commonly used grafts are hamstring graft and bone patellar tendon bone graft. In this study we are highlighting anatomical anterior cruciate ligament reconstruction by hamstring autograft. This study was undertaken to evaluate the results of arthroscopic anatomical anterior cruciate ligament reconstruction with hamstring graft using lysholm knee scoring scale.     

This is the study of 40 cases of arthroscopic anterior cruciate ligament reconstruction using hamstring autograft in our institute with minimum follow up of 6 months.     

Results in this study are calculated according to lysholm knee score. 55% patients showed excellent results, 40% patients showed good results and 5% patients showed fair results. Average lysholm score is 90 in 40 patients.   

Anatomical anterior cruciate ligament reconstruction using hamstring graft technique has yielded excellent to good results in almost all patients with minimal complication and provides stable knees.

We read with great interest the article “How to Avoid Common Complications in Hamstrings Harvest for Anterior Cruciate Ligament Reconstruction: A Practical Guide” by Familiari, F. et al. We have read with great interest the article detailing various surgical techniques, particularly the section on hamstring harvest. However, after a thorough review of the article, we believe that there are some crucial details within the "hamstring harvest" section that require further clarification to enhance the understanding of readers and to prevent potential pitfalls during this surgical procedure.

Graft type selection is still a controversial issue in anterior cruciate ligament (ACL) reconstruction. The type of graft is a determinant of return to sport and its quality.

This study aims to evaluate results and rate of return to sport using quadriceps autograft compared to hamstring autograft.

The present prospective cohort study investigated the results of using quadriceps and hamstring autografts in athletes with an ACL tear. Our variables included age, sex, and body mass index, type of sports activity, infection, meniscus tear and chondral lesion, time and quality of return to sport, range of motion, KT-1000, Lachman and knee injury and osteoarthritis outcome score, international knee documentation committee grade, and Lysholm score.

A total of 71 out of 139 studied patients were operated on hamstring autografts and 68 patients by quadriceps autografts. The patients showed no significant differences (P>0.05) in terms of age, sex, body mass index, sports group, and meniscus tear. In the final follow-up, the chondral lesion was 26.47 vs 16.90, anterior knee pain was 5.8 vs 2.81, and the return to sport was 71.64 vs 78.87 in the quadriceps group vs the hamstring group. The extension loss involved 2 patients per group. The scores of the international knee documentation committee and knee injury and osteoarthritis outcome, the Lysholm test, KT-1000, and the Lachman test had no significant differences in the two groups.

The results of the present study indicated that the use of both quadriceps and hamstring autografts was appropriate for the ACL tear. Also, the orthopedic surgeon should be responsible for deciding to select one of the two grafts.

This study aimed to investigate the immediate effect of kinesio taping (KT) over abdominal muscles with different tensions on the components of the lumbopelvic complex.

This is a single-blind randomized controlled clinical trial. Participants were 44 healthy male athletes aged 18-30 years with increased anterior pelvic tilt (PT). Three intervention groups underwent 15 minutes of KT over rectus abdominis and external oblique muscles with tensions of 100, 115, and 140%, respectively, and one group was considered as the control group with no KT. The PT and lumbar lordosis angles and iliopsoas and hamstring muscle lengths were measured before and after the KT. Repeated measures ANOVA was used to compare the means in the study groups before and after the intervention.

The mean of right and left PT and lumbar lordosis angles in groups with 115 and 140% tensions before and after the intervention were statistically different (P<0.05). Moreover, the mean of right and left PT and lumbar lordosis angles showed a significant difference between the groups after the intervention (P<0.05). There was a significant difference in active and passive hamstring lengths on both sides in the group received KT with 140% tension before and after the intervention (P<0.05).

Kinesio taping with high tension on rectus abdominis and external oblique muscles can reduce their PT angle and lumbar lordosis and increase hamstring muscle length in men with increased anterior PT. This issue should be considered in lumbopelvic complex physiotherapy.

Object: 

Data regarding the diagnosis of Proximal Hamstring Tendinopathy (PHT) is limited. There is a need for a standardized, valid, and reliable instrument for evaluating PHT among Spanish population. The purpose of this study was to linguistically validate and cross-culturally adapt the Spanish version of the VISA-H for Spanish population and to assess its readability, initial feasibility, appropriateness and acceptability.

Cross-cultural adaptation was done according to established guidelines. Process included 5 steps: independent translations, synthesis of the translations, back-translations, expert committee, and pre-test. The linguistic validation of the questionnaire followed a standard methodology that included comprehension test interviews to assess the relevance, understanding and acceptability of the VISA-H. Comprehension was analyzed with cognitive interviews of 18 Spanish Professional basketball and soccer players (n = 8 male, n = 10 female end-users, healthy individuals at risk), using think-aloud and probing techniques.

All subjects (18/18) reported that the items were clear and did not cause upset. Additionally, every respondent had no difficulty in completing the form and found it fairly easy. No difficulties with the instructions were reported. Readability score resulted in adequate levels of understanding (Fernandez-Huerta score of 67.5), showing high level of acceptability.

The results of the linguistic and semantic validation conducted with health risky population enable the identification that the Sp-VISA-H was well accepted and easily understood by the participants. Further testing on PHT patients is needed to corroborate these preliminary data.

The length and number of accessory bands of gracilis and semitendinosus tendons have high variability among Asian population. Complications during graft harvesting might occur if the surgeon cannot correctly identify these complex structures.

We performed cadaveric knee specimen dissections (level of evidence: level III; descriptive laboratory study (anatomical study)). Each of the accessory bands arising from semitendinosus and gracilis tendons was identified. Size and distance from the origin of accessory bands to the tibial insertion were measured.

Eighty knees were included in the study. For the semitendinosus tendon, we found the following accessory bands in our specimens: no accessory bands in 6%, one band in 56%, and two bands in 38%. The longest distance of an accessory band from tibial insertion was 9.8 cm, with an average distance for the first band of 4.5 cm. The number of accessory bands for the gracilis tendon was, as follows: 0, 1, 2, 3 and 4 in 20, 39, 31, 9, and 1%, respectively. The longest distance of accessory band was 9.33 cm from tibial insertion, with an average distance for the first band of 4.7 cm. We found the width of accessory bands in females to be wider than males (P = 0.0001) and the width of accessory bands in right knees to be wider than those in left knees (P = 0.04).

In Asian populations, we found high variability of number of accessory bands from semitendinosus and gracilis tendons. The average distance from the tibial insertion to the first accessory band was 4.5 cm. None of the bands arised more than 10 cm from the tibial insertion.

Initial fixation strength is critical for the early post-operative rehabilitation of patients with anterior cruciate ligament (ACL) reconstructions. However, even the best femoral fixation devices remain controversial. We compared the results of 2 of the femoral fixation techniques,Rigidfix and Transfix.

A total of 30 patients with unilateral ACL deficiency were randomly assigned to 1 of 2 groups. In Group A an anatomic single-bundle ACL reconstruction was performed using Rigidfix technique(Mitek, Norwood,MA), Group B were treated by a single bundle using Transfix technique(Arthrex, Naples, FL, USA). For tibial fixation, a bioabsorbable Intrafix interference screw was used for all the groups and the graft was fashioned from the semitendinosus and gracilis tendons in all patients. The patients were subjected to a clinical evaluation, with assessment of the anterior drawer, Lachman’s and the pivot-shift tests. They also completed the International Knee Documentation Committee (IKDC) score.

At a mean of 14 months (12–17) followup there were no significant differences concerning time between injury and range of movement between the 2 groups. However, the Rigidfix group showed significantly better results for the subjective assessment of knee function (P = 0.002). The Lachman, anterior drawer, and pivot-shift tests also showed no significant difference between the 2 groups. The IKDC scale showed no significant difference among the groups (P < 0.001).There was no difference regarding duration of operation and cost of the operation between the 2 groups.On clinical evaluation there was no significant difference between the 2 groups. However, regardless of the technique, all knees were improved by ACL reconstruction compared with their preoperative status.

Both techniques can be used for reconstruction of ACL. Other factors, such as psychic profile of the patients should be considered for surgery planning.