| Objective: To explore the reasonable clipping method of autologous hamstring tendon in the reconstruction of anterior cruciate ligament(ACL)of the knee,so as to provide an optimal scheme for making full use of high-quality tendon and initially explore the method of accurate tendon extraction.Methods: Adopt the method of prospective cohort study,collected a total of 107 cases who have underwent anterior cruciate ligament reconstruction with autogenous hamstring tendons in the second People’s hospital of Yueyang sports medicine from December 2016 to March2019,the normal adult values mean and range of grafts were concluded by measuring the length of the grafts,practical application in the body part and cut off the excess length,then usually cut off excess length value as can be converted to woven premise before cutting to length,and cut off the excess length in advance(transitional)is located in the inferior tendon part only,to ensure all quality tendon transplantation in the body.Results: Value has been measured from in the 107 cases,the mean total length of semitendinosus tendon was(284.4 ±15.5)mm,the length of pure tendon was(136.9 ±5.9)mm,and the length of transitional part was(147.5 ±12.8)mm;the total length of gracilis tendon was(247.3 ±15.2)mm,the length of pure tendon was(127.3 ±7.4)mm,the length of transitional part was(119.9 ±11.1)mm;the total length of grafttransplanted in vivo after braiding: the length of graft required in the femoral tunnel is(23.1 ±2.2)mm,the length of graft required in the tibial tunnel is(32.9 ±2.6)mm,the length of graft required in the articular cavity is(17.2 ±2.5)mm;The average total length of the discarded tendons of semitendinosus and gracilis were(135.3 ±16.0)mm and(98.1±15.4)mm,respectively,half of the discarded tendons were high quality tendons,and half of them were inferior tendons.The length of high quality tendons abandoned by semitendinosus and gracilis tendon was(67.6 ±8.00)mm and(49.1 ±7.7)mm,respectively.That is,all patients in this group have a considerable number of high-quality tendons removed and discarded,causing the human body to use the waste of tissue.According to the required tendon length,all the distal high quality tendons are retained,and the redundant inferior tendons are cut directly,which not only reduces the donor injury,but also improves the quality of the graft.Pearson linear correlation analysis showed that the total length of semitendinosus and gracilis muscle tendons was positively correlated with the length of pure tendinous part,and the length of pure tendinous part was positively correlated with the total length of semitendinosus tendon and the length of pure tendinous part.According to the data of the actual length of the graft and the length of the tendon in each patient,it was found that there are only 9 cases(8.4%),whose pure tendon part of the semitendinosus muscle could meet the need of reconstruction,98 cases(91.6%)could not,and the maximum length of the displaced tendon needed to be used was 29 mm;there are only 2 cases(1.9%)could meet the need of reconstruction,105 cases(98.1%)could not,the maximum length of the displaced tendon needed to be used was 41 mm.Conclusions:In the reconstruction of ACL autogenous by using hamstring tendons reconstruction,the mean graft length that needed during the intraoperative is(75.5 ±2.4)mm,and there was a rather longtendon had been discarded,the average length of semitendinosus and gracilis tendons were(135.3 ±16.0)mm and(98.1 ±15.4)mm respectively,and the part of high quality tendons were 67.7mm and49.1mm respectively.In the future,according to the value of the tendon had been wasted,the proximal inferior tendon can be directly cut off before weaving,and the distal high quality tendon can be retained to improve the graft quality.The length of hamstring tendon is positively related to the pure tendon part.In some patients,only the tendinous part can meet the need of reconstruction. |
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