Purpose: To investigate the usefulness of the ââ?¬Å?inducer graftingââ?¬Â technique for regeneration of the semitendinosus\r\n(ST) tendon after its harvest for anterior cruciate ligament (ACL) reconstruction.\r\nMethods: Twenty knees of 20 patients (mean age at the time of surgery, 23.1 years) underwent ACL reconstruction\r\nwith a double bundle autograft using the ST tendon (7 patients) and the ST + the gracilis (G) tendons (13 patients).\r\nââ?¬Å?Inducer graftingââ?¬Â technique\r\nAfter harvesting the ST tendon, a passing pin with a loop thread is inserted along with the tendon stripper. The\r\npassing pin is pulled out from the medial thigh and the loop thread retained. As an inducer graft, the ST tendon\r\nbranch is used. After the ACL graft has been secured, the inducer graft is sutured to the pes anserinus and the\r\nproximal end passed through by pulling the thread out. Then the inducer graft is placed within the tendon canal.\r\nThe mean follow-up period was 15 months. The presence and morphology of the regenerated ST tendon were\r\nexamined by MRI. And the isometric hamstring strength was examined at 45Ã?°, 90Ã?° and 120Ã?° of knee flexion.\r\nResults: One month after the operation in all the patients, MRI demonstrated a low-intensity structure at the\r\nanatomical location of the ST, at the level of the superior pole of the patella and the joint line, apparently\r\nrepresenting the regenerated ST tendon. Four months after the operation, the distal portion of the regenerated ST\r\ntendon had reached the pes anserinus in all patients. Twelve months after the operation, the regenerated ST\r\ntendon was hypertrophic in 19 of the 20 patients (95%). The isometric knee flexion torque of the ACL-reconstructed\r\nlimb was significantly lower at 90Ã?° and 120Ã?° compared with the contralateral limb.\r\nConclusion: These results suggest that the ââ?¬Å?inducer graftingââ?¬Â technique is able to improve the regeneration rate of\r\nthe harvested ST tendon and promote hypertrophy of the regenerated ST tendon, extending all the way to the pes\r\nanserinus. However, this technique couldnââ?¬â?¢t improve the deficits in knee flexion torque after ACL reconstruction
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