Correlation study on the influencing factors of semitendinosus insertion location_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

Yalikun·Yusufu ^1,2 , ZHANG Yu ^1,2 , CHEN Dongyang ^1,2 ,  JIANG Qing ^1,2

1. Division of Sports Medicine and Adult Reconstructive Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing Jiangsu, 210008, P. R. China;
2. Branch of National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Nanjing Jiangsu, 210008, P. R. China;

Corresponding author：

JIANG Qing, Email: qingj@nju.edu.cn

Keywords：

Semitendinosus insertion; tibial plateau; autogenous tendon graft; anterior cruciate ligament reconstruction

DOI：

10.7507/1002-1892.202303063

Video：

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Objective To investigate the relationship between the vertical distance from semitendinosus insertion to tibial plateau (S-T) and the physical characteristics of patients, in order to provide reference for incision design to expose the semitendinosus insertion. Methods The patients with ligament injury who underwent primary anterior cruciate ligament reconstruction between January 2022 and December 2022 were selected as the research subjects. The patients’ baseline data were collected, including age, gender, height, and body mass. During reconstruction operation, the S-T was measured. Considering the S-T as the dependent variable and baseline data as the independent variable, multiple linear regression analysis was used to establish a regression equation to determine the possible influencing factors of semitendinosus insertion location. Results According to the selection standard, a total of 214 patients were enrolled, including 156 males and 58 females, aged (27±9) years (14-49 years), with a height of (174.7±6.8) cm (range, 160-196 cm) and a body mass of (73.43±12.35) kg (range, 53-105 kg). The S-T was (56.36±3.61) mm (range, 47-67 mm). The multiple linear regression analysis results showed that the height was positively correlated with S-T (β=0.407, SE=0.055, t=7.543, P<0.001); the regression equation was S-T=−14.701+0.407×height, R²=0.690. Conclusion There was a linear relationship between the height and semitendinosus insertion. The location of semitendinosus insertion estimated by the formula (S-T=−14.701+0.407×height) is reasonable, which provides a theoretical basis for rapid, accurate, and safe location of semitendinosus insertion and design of surgical incision in clinic.

Citation： Yalikun·Yusufu, ZHANG Yu, CHEN Dongyang, JIANG Qing. Correlation study on the influencing factors of semitendinosus insertion location. Chinese Journal of Reparative and Reconstructive Surgery, 2023, 37(8): 978-981. doi: 10.7507/1002-1892.202303063 Copy

1.	Mackay GM, Blyth MJ, Anthony I, et al. A review of ligament augmentation with the InternalBrace^TM: the surgical principle is described for the lateral ankle ligament and ACL repair in particular, and a comprehensive review of other surgical applications and techniques is presented. Surg Technol Int, 2015, (26): 239-255.
2.	Mohtadi NG, Chan DS, Dainty KN, et al. Patellar tendon versus hamstring tendon autograft for anterior cruciate ligament rupture in adults. Cochrane Database Syst Rev, 2011, 2011(9): CD005960. doi: 10.1007/s11999-017-5278-9.
3.	Kaeding CC, Pedroza AD, Reinke EK, et al. Change in anterior cruciate ligament graft choice and outcomes over time. Arthroscopy, 2017, 33(11): 2007-2014.
4.	Wang HD, Zhang H, Wang TR, et al. Comparison of clinical outcomes after anterior cruciate ligament reconstruction with hamstring tendon autograft versus soft-tissue allograft: A meta-analysis of randomised controlled trials. Int J Surg, 2018, 56: 174-183.
5.	王林林, 陈亚洲, 刘培倦, 等. 自体移植、同种异体移植、混合移植在关节镜下前交叉韧带重建中的效果研究. 吉林医学, 2021, 42(11): 2606-2609.
6.	Belk JW, Kraeutler MJ, Marshall HA, et al. Quadriceps tendon autograft for primary anterior cruciate ligament reconstruction: a systematic review of comparative studies with minimum 2-year follow-up. Arthroscopy, 2018, 34(5): 1699-1707.
7.	Dai W, Leng X, Wang J, et al. Quadriceps tendon autograft versus bone-patellar tendon-bone and hamstring tendon autografts for anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Am J Sports Med, 2022, 50(12): 3425-3439.
8.	Johnston PT, McClelland JA, Feller JA, et al. Knee muscle strength after quadriceps tendon autograft anterior cruciate ligament reconstruction: systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2021, 29(9): 2918-2933.
9.	Powell CW, Norton CD, Colon LF, et al. Quadruple hamstring autograft technique for anterior cruciate ligament reconstruction reduces allograft augmentation. Arthrosc Sports Med Rehabil, 2022, 4(6): e2059-e2063.
10.	Assi C, Bonnel F, Mansour J, et al. The gracilis and semitendinosus muscles: a morphometric study on 18 specimens with clinical implications. Surg Radiol Anat, 2022, 44(6): 813-820.
11.	Grassi A, Perdisa F, Samuelsson K, et al. Association between incision technique for hamstring tendon harvest in anterior cruciate ligament reconstruction and the risk of injury to the infra-patellar branch of the saphenous nerve: a meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2018, 26(8): 2410-2423.
12.	Curtis BR, Huang BK, Pathria MN, et al. Pes anserinus: anatomy and pathology of native and harvested tendons. AJR Am J Roentgenol, 2019, 213(5): 1107-1116.
13.	Reina N, Abbo O, Gomez-Brouchet A, et al. Anatomy of the bands of the hamstring tendon: how can we improve harvest quality? Knee, 2013, 20(2): 90-95.
14.	汪淼, 冯泽坤, 陆子轩, 等. 鹅足区肌腱止点的形态学特点及其意义. 中国临床解剖学杂志, 2016, (1): 46-49.
15.	Kerver AL, Leliveld MS, den Hartog D, et al. The surgical anatomy of the infrapatellar branch of the saphenous nerve in relation to incisions for anteromedial knee surgery. J Bone Joint Surg (Am), 2013, 95(23): 2119-2125.
16.	Sengoku T, Nakase J, Asai K, et al. The effect of gracilis tendon harvesting in addition to semitendinosus tendon harvesting on knee extensor and flexor strength after anterior cruciate ligament reconstruction. Arch Orthop Trauma Surg, 2022, 142(3): 465-470.
17.	Olivos-Meza A, Suarez-Ahedo C, Jiménez-Aroche CA, et al. Anatomic considerations in hamstring tendon harvesting for ligament reconstruction. Arthrosc Tech, 2020, 9(1): e191-e198.
18.	Kalthur SG, Sumalatha S, Nair N, et al. Anatomic study of infrapatellar branch of saphenous nerve in male cadavers. Ir J Med Sci, 2015, 184(1), 201-206.
19.	Luo J, Li S, Wang C, et al. Optimization of surgical exposure for harvesting gracilis-semitendinosus tendons. Int Orthop, 2023, 47(1): 131-140.
20.	Xu J, Fu D, Peng Y, et al. A case report: anatomical translocation in tibial insertion of semitendinosus tendon after tibial lengthening. BMC Musculoskelet Disord, 2022, 23(1): 936. doi: 10.1186/s12891-022-05890-w.
21.	Zumwalt A. The effect of endurance exercise on the morphology of muscle attachment sites. J Exp Biol, 2006, 209(Pt 3): 444-454.
22.	Rabey KN, Green DJ, Taylor AB, et al. Locomotor activity influences muscle architecture and bone growth but not muscle attachment site morphology. J Hum Evol, 2015, 78: 91-102.

1. Mackay GM, Blyth MJ, Anthony I, et al. A review of ligament augmentation with the InternalBrace^TM: the surgical principle is described for the lateral ankle ligament and ACL repair in particular, and a comprehensive review of other surgical applications and techniques is presented. Surg Technol Int, 2015, (26): 239-255.
2. Mohtadi NG, Chan DS, Dainty KN, et al. Patellar tendon versus hamstring tendon autograft for anterior cruciate ligament rupture in adults. Cochrane Database Syst Rev, 2011, 2011(9): CD005960. doi: 10.1007/s11999-017-5278-9.
3. Kaeding CC, Pedroza AD, Reinke EK, et al. Change in anterior cruciate ligament graft choice and outcomes over time. Arthroscopy, 2017, 33(11): 2007-2014.
4. Wang HD, Zhang H, Wang TR, et al. Comparison of clinical outcomes after anterior cruciate ligament reconstruction with hamstring tendon autograft versus soft-tissue allograft: A meta-analysis of randomised controlled trials. Int J Surg, 2018, 56: 174-183.
5. 王林林, 陈亚洲, 刘培倦, 等. 自体移植、同种异体移植、混合移植在关节镜下前交叉韧带重建中的效果研究. 吉林医学, 2021, 42(11): 2606-2609.
6. Belk JW, Kraeutler MJ, Marshall HA, et al. Quadriceps tendon autograft for primary anterior cruciate ligament reconstruction: a systematic review of comparative studies with minimum 2-year follow-up. Arthroscopy, 2018, 34(5): 1699-1707.
7. Dai W, Leng X, Wang J, et al. Quadriceps tendon autograft versus bone-patellar tendon-bone and hamstring tendon autografts for anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Am J Sports Med, 2022, 50(12): 3425-3439.
8. Johnston PT, McClelland JA, Feller JA, et al. Knee muscle strength after quadriceps tendon autograft anterior cruciate ligament reconstruction: systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2021, 29(9): 2918-2933.
9. Powell CW, Norton CD, Colon LF, et al. Quadruple hamstring autograft technique for anterior cruciate ligament reconstruction reduces allograft augmentation. Arthrosc Sports Med Rehabil, 2022, 4(6): e2059-e2063.
10. Assi C, Bonnel F, Mansour J, et al. The gracilis and semitendinosus muscles: a morphometric study on 18 specimens with clinical implications. Surg Radiol Anat, 2022, 44(6): 813-820.
11. Grassi A, Perdisa F, Samuelsson K, et al. Association between incision technique for hamstring tendon harvest in anterior cruciate ligament reconstruction and the risk of injury to the infra-patellar branch of the saphenous nerve: a meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2018, 26(8): 2410-2423.
12. Curtis BR, Huang BK, Pathria MN, et al. Pes anserinus: anatomy and pathology of native and harvested tendons. AJR Am J Roentgenol, 2019, 213(5): 1107-1116.
13. Reina N, Abbo O, Gomez-Brouchet A, et al. Anatomy of the bands of the hamstring tendon: how can we improve harvest quality? Knee, 2013, 20(2): 90-95.
14. 汪淼, 冯泽坤, 陆子轩, 等. 鹅足区肌腱止点的形态学特点及其意义. 中国临床解剖学杂志, 2016, (1): 46-49.
15. Kerver AL, Leliveld MS, den Hartog D, et al. The surgical anatomy of the infrapatellar branch of the saphenous nerve in relation to incisions for anteromedial knee surgery. J Bone Joint Surg (Am), 2013, 95(23): 2119-2125.
16. Sengoku T, Nakase J, Asai K, et al. The effect of gracilis tendon harvesting in addition to semitendinosus tendon harvesting on knee extensor and flexor strength after anterior cruciate ligament reconstruction. Arch Orthop Trauma Surg, 2022, 142(3): 465-470.
17. Olivos-Meza A, Suarez-Ahedo C, Jiménez-Aroche CA, et al. Anatomic considerations in hamstring tendon harvesting for ligament reconstruction. Arthrosc Tech, 2020, 9(1): e191-e198.
18. Kalthur SG, Sumalatha S, Nair N, et al. Anatomic study of infrapatellar branch of saphenous nerve in male cadavers. Ir J Med Sci, 2015, 184(1), 201-206.
19. Luo J, Li S, Wang C, et al. Optimization of surgical exposure for harvesting gracilis-semitendinosus tendons. Int Orthop, 2023, 47(1): 131-140.
20. Xu J, Fu D, Peng Y, et al. A case report: anatomical translocation in tibial insertion of semitendinosus tendon after tibial lengthening. BMC Musculoskelet Disord, 2022, 23(1): 936. doi: 10.1186/s12891-022-05890-w.
21. Zumwalt A. The effect of endurance exercise on the morphology of muscle attachment sites. J Exp Biol, 2006, 209(Pt 3): 444-454.
22. Rabey KN, Green DJ, Taylor AB, et al. Locomotor activity influences muscle architecture and bone growth but not muscle attachment site morphology. J Hum Evol, 2015, 78: 91-102.

Chinese Journal of Reparative and Reconstructive Surgery

Correlation study on the influencing factors of semitendinosus insertion location

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