Department of Orthopedics, NU-Hospital Organization, Trollhättan/Uddevalla, Sweden. ; University of Gothenburg, Gothenburg, Sweden.
Department of Plastic Surgery, Sahlgrenska University Hospital, Sahlgrenska, Sweden.
Orthop J Sports Med. 2014 Sep 22;2(9):2325967114550274. doi: 10.1177/2325967114550274. eCollection 2014 Sep.
Semitendinosus (ST) and/or gracilis (G) autografts are the most used grafts for anterior cruciate ligament (ACL) surgery. The tendons have been shown to be able to regenerate but with focal areas of scar tissue in the short term. There are no long-term histological studies of the regenerated tendons.
In the long term, the regenerated ST tendon normalizes and has a similar histology as the contralateral nonharvested tendon.
Case-control study; Level of evidence, 3.
Eighteen patients (8 female, 10 male) who underwent ACL surgery using ipsilateral ST/G tendon autografts were included in this study. Percutaneous specimens were obtained from the regenerated ST tendon and the contralateral nonharvested ST tendon under ultrasonographic guidance at a median of 8.4 years (100.5 months; range, 77-129 months) after the harvest procedure. Specimens from the nonoperated side served as controls. The histology and presence of glycosaminoglycans (GAGs) were assessed using a light microscope and a semiquantitative grading system.
Thirty-six biopsies were obtained (2 biopsies from each patient). In 5 biopsies, the amount of tissue was too small to analyze in the light microscope, and 1 patient had been operated on bilaterally and was therefore excluded. In total, 24 biopsies were included in the histological analysis. In overall terms, there were no significant differences between the regenerated and nonharvested ST tendon in terms of fiber structure, cellularity, vascularity, and level of GAGs a minimum 6 years after harvest of the ST tendon. However, 3 of the regenerated tendons displayed a loss of fiber structure.
The ST tendon regenerates and may regain a histological appearance similar to that of the nonharvested contralateral tendon, as seen in this study a median of 8.4 years after harvesting. However, in some tendons, loss of fiber structure was found.
半腱肌（ST）和/或股薄肌（G）自体移植物是前交叉韧带（ACL）手术中最常用的移植物。已经证明肌腱能够再生，但在短期内会有局部瘢痕组织。目前尚无关于再生肌腱的长期组织学研究。
从长远来看，再生的 ST 肌腱会恢复正常，并且具有与对侧未采集肌腱相似的组织学特性。
病例对照研究；证据水平，3 级。
本研究纳入了 18 名（8 名女性，10 名男性）接受同侧 ST/G 肌腱自体移植物 ACL 手术的患者。在肌腱采集后中位数 8.4 年（100.5 个月；范围，77-129 个月）时，在超声引导下从再生的 ST 肌腱和对侧未采集的 ST 肌腱中经皮获取标本。未手术侧的标本作为对照。使用光学显微镜和半定量分级系统评估组织学和糖胺聚糖（GAGs）的存在。
共获得 36 个活检标本（每位患者 2 个活检）。在 5 个活检中，组织量太小，无法在光学显微镜下进行分析，并且 1 名患者双侧均接受了手术，因此被排除在外。共有 24 个活检标本纳入组织学分析。总体而言，在肌腱采集后至少 6 年，再生和未采集的 ST 肌腱在纤维结构、细胞密度、血管生成和 GAG 水平方面没有显著差异。然而，3 个再生的肌腱显示出纤维结构的丧失。
本研究中，在肌腱采集后中位数 8.4 年，ST 肌腱再生并可能恢复与对侧未采集肌腱相似的组织学外观。然而，在一些肌腱中，发现纤维结构丧失。
