Albertoni Leonardo José Bernades, Debieux Pedro, Franciozi Carlos Eduardo da Silveira, Novaretti João Victor, Granata Geraldo Sergio de Melo, Luzo Marcus Vinicius Malheiros
Knee Surgery and Arthroscopy Group, Universidade Federal de São Paulo (UNIFESP-EPM), São Paulo, SP Brazil.
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Acta Ortop Bras. 2018;26(6):379-383. doi: 10.1590/1413-785220182606168849.
To evaluate the regenerative capacity of gracilis (G) and semitendinosus (ST) tendons, to examine the sensitivity and specificity of signs and symptoms in the assessment of hamstring tendons, and to assess the thickness and insertion site of regenerated tendons.
Thirty sequential knees were subjected to anterior cruciate ligament reconstruction with semitendinosus and gracilis tendons. After surgery, the patients were followed up clinically with physical examination and magnetic resonance imaging (MRI).
Overall, 36.66% of the tendons were visible on MRI, whereas 83.33% were palpable. On MRI, the distal insertion site of the regenerated semitendinosus tendon was visible proximal to the landmark of the medial femoral condyle in 28%, at the same level in 16%, and distally in 56% of the cases. Gracilis tendon insertion was visible proximally in 36.66% of cases, at the same level in 10%, and distally in 53.33%. Eleven knees exhibited complete regeneration.
Partial or total regeneration of the ST and G tendons was apparent on MRI. Palpation is effective for evaluating regeneration of the ST and G tendons; however, MRI is still the gold standard. ST and G tendons regenerated completely in only a small percentage of patients, limiting reuse as a graft in cases with new ligament injuries of the knee.
评估股薄肌（G）和半腱肌（ST）肌腱的再生能力，检查体征和症状在评估腘绳肌腱时的敏感性和特异性，并评估再生肌腱的厚度和附着部位。
连续30例膝关节接受半腱肌和股薄肌腱重建前交叉韧带手术。术后，对患者进行临床随访，包括体格检查和磁共振成像（MRI）。
总体而言，36.66%的肌腱在MRI上可见，而83.33%可触及。在MRI上，再生半腱肌腱的远端附着部位在28%的病例中位于股骨内侧髁标志近端可见，16%在同一水平可见，56%在远端可见。股薄肌腱附着部位在36.66%的病例中近端可见，10%在同一水平可见，53.33%在远端可见。11例膝关节表现为完全再生。
MRI显示ST和G肌腱有部分或完全再生。触诊对评估ST和G肌腱的再生有效；然而，MRI仍然是金标准。ST和G肌腱仅在一小部分患者中完全再生，限制了其在膝关节新的韧带损伤病例中作为移植物的再次使用。
