Surg Radiol Anat. 2021 Mar 23. doi: 10.1007/s00276-021-02738-1. Online ahead of print.
ABSTRACT
PURPOSE: Semitendinosus and gracilis muscles whose tendons are used in surgical reconstruction of the anterior cruciate ligament maintain their contractile ability, but the peak torque angle of hamstring muscles shifted to a shallow angle postoperatively. The goal was to quantify the influence of the myofascial structures on instantaneous moment arms of knee muscles to attempt exp laining the above-mentioned post-surgical observations.
METHODS: Hamstring harvesting procedures were performed by a senior orthopaedic surgeon on seven lower limbs from fresh-frozen specimens. Femoro-tibial kinematics and tendons excursion were simultaneously recorded at each step of the surgery.
RESULTS: No significant difference was demonstrated for instantaneous moment arm of gracilis during anterior cruciate ligament surgery (84% of the maximum intact values; P ≥ 0.05). The first significant semitendinosus moment arm decrease was observed after tendon harvesting (61% of the maximum intact values; p ≤ 0.005). After hamstring harvesting, the maximum and minimum moment arm (both gracilis and semi tendinosus) shifted to a shallow angle and 90°, respectively.
CONCLUSION: Moment arm modifications by paratenons and the loose connective tissue release are essential to understand the peak torque obtained to a shallow angle.
LEVEL OF EVIDENCE: Basic science s tudy, biomechanics.
PMID:33755756 | DOI:10.1007/s00276-021-02738-1
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