Three-dimensional computed tomography evaluation of semitendinosus harvest after anterior cruciate ligament reconstruction.

PURPOSE

Recent studies have shown the regeneration potential of hamstring tendons harvested for anterior cruciate ligament (ACL) reconstruction. The purpose of this study was to evaluate the morphology of the regenerated semitendinosus tendon using 3-dimensional (3-D) images of volume-rendered multidetector helical computed tomography (MD-CT).

TYPE OF STUDY

Retrospective study on a convenient sample of patients.

METHODS

Eight patients were selected from those with a minimum 2-year follow-up evaluation after ACL reconstruction with hamstring tendons. The harvest site of the semitendinosus tendon was evaluated using 3-D CT, in addition to magnetic resonance imaging (MRI) analysis, at an average of 37 months (range, 27 to 47 months) after surgery.

RESULTS

In 5 of 8 patients, MRI evaluation indicated recurrence of the region with the same signal intensity as the native at the harvest site of the semitendinosus tendon. In these patients, the 3-D image of MD-CT visualized the stringy tendinous tissue regenerated at the harvest site originating from the semitendinosus muscle belly and running in the same pathway as the native tendon. However, the distal part attached into the medial surface of the popliteal fascia. By contrast, in the involved sides of the remaining 3 patients with no detection on MRI, the 3-D CT image showed no tendinous tissue at the harvest site. The remnants of the semitendinosus had reduced or fused into the muscle belly of the semimembranous.

CONCLUSIONS

Using the 3-D CT technique, we could first depict the distinct morphology of the regenerate at the harvest site of the semitendinosus tendon.

LEVEL OF EVIDENCE

Level IV, therapeutic study.