Comparison of Tendon and Muscle-Tendon Semitendinosus Grafts After ACL Reconstruction
Comparison of Bone Ingrowth and Intra-articular Remodeling of Autologous Tendon and Muscle-tendon Semitendinosus Graft After Arthroscopic Anterior Cruciate Ligament Reconstruction Surgery
University Hospital Dubrava
40 participants
Feb 1, 2026
INTERVENTIONAL
Conditions
Summary
Aim: Comparison of tendon to bone ingrowth in bone tunnels and intra-articular remodeling of the graft after anterior cruciate ligament surgery with a muscle-tendon graft and those with a tendon graft. Subjects and methods: It is a single-blind prospective randomized study that would include at least 40 patients with an anterior cruciate ligament rupture. Patients would be randomly divided into two groups of minimally 20 patients each. Patients in the first study group would undergo ACL reconstruction with a muscle-tendon graft, while patients in the control group would be treated with the standard method of ACL reconstruction with a tendon graft. Expected contribution to the field: The assumption is that the obtained results could enable a better understanding of the contribution of remaining muscle fibers on the tendon in anterior cruciate ligament reconstruction operations to the tendon to bone ingrowth and intra-articular remodeling of the graft of operated patients.
Eligibility
Inclusion Criteria5
- Clinically and radiologically confirmed anterior cruciate ligament (ACL) rupture.
- Age between 18 and 50 years.
- Intact posterior cruciate ligament and collateral ligaments.
- Signed informed consent to participate in the study.
- Patients meeting at least one indication for concomitant lateral tenodesis, including: age under 25 years, positive pivot-shift test, presence of Segond fracture, participation in sports with frequent changes of direction and rotational knee loads, or joint hypermobility (Beighton score ≥ 7).
Exclusion Criteria5
- Previous ACL reconstruction of the same knee.
- Inability to use a graft prepared by quadruple folding of the semitendinosus tendon.
- Graft diameter < 7.5 mm.
- MRI-confirmed unsuccessful meniscal healing after repair.
- Acute joint infection or history of joint infection.
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Interventions
Participants will undergo arthroscopic all-inside anterior cruciate ligament reconstruction using an autologous semitendinosus graft. In the experimental intervention, a muscle-tendon semitendinosus graft is used, with preservation of muscle fibers on the tendon. In the control intervention, a standard tendon-only semitendinosus graft is used. In both groups, graft preparation, tunnel creation, fixation technique, and concomitant lateral tenodesis are identical, and all procedures are performed by the same surgeon following a standardized protocol.
Locations(1)
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NCT07404046