Estudio anatómico de las porciones tendinosas de los músculos semitendinoso y grácil aplicado a la reconstrucción del ligamento cruzado anterior

Abstract

Introduction: anterior cruciate ligament (ACL) using autologous hamstring graft, with gracilis and semitendinosus muscles tendons, has gained popularity. Incision emplacement for harvesting the aforementioned graft, and tissue availability are key points when considering its utilization. Cadaveric and ultrasonography study allows a better evaluation of its properties, with surgical application.

Materials and methods: descriptive cross-sectional study. Twenty-four adult formaldehyde-fixed lower limbs were dissected, there were limbs of both sexes. Soft tissue ultrasonography was performed in eighteen lower limbs of adults of both sexes. The tendons of the gracilis and semitendinosus muscles were measured in length and diameter. Their insertion was surveyed in relation to tibial anterior border (TAB) and joint line (JL). The results obtained were compared, with a p value <0.05 considered significant.

Results: in cadaveric study, mean insertion site for gracilis was 2.7 cm medial to TAB and 4.6 distal to JI, and for semitendinosus it was 2.7 cm medial to TAB and 5.7 cm distal to JI. Diameter and length of tendon was 0.55 cm and 13.29 cm respectively for gracilis, and 0.68 cm and 16.42 for semitendinosus. Ultrasonography showed statistically different results for all variables. Significant lineal regressions were established between leg length and tendon length or distance of insertion to JI.

Conclusions: the present study provides precise information on the insertion point of both muscles, applied to ACL reconstruction. Morphological properties of both tendons allow their use as grafts. Ultrasound did not show comparable results with cadaveric study.