The effect of initial graft tension on postoperative clinical outcome in anterior cruciate ligament reconstruction with semitendinosus tendon.

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The goal of this study is to establish the influence of tensioning the graft during anterior cruciate ligament (ACL) reconstruction, with a semitendinosus tendon graft, on postoperative stability.

Type of study:

Prospective controlled clinical trial.

Material and methods:

Forty-eight patients were randomly allocated to three groups in which three different tensions, 8, 12, or 15 kg force, was applied on the reconstructed ACL during the operation. The patients were observed for 1 year or more after surgery (min. 1 year, max. 2 years 8 months). Clinical outcome was evaluated using the visual analogue scale, anterior knee laxity (using the KT2000 arthrometer) and the torque of the knee extensor.


Postoperatively, the average side-to-side differences in anterior laxity were 1.3 mm in the 8 kg group, 2.1 mm in the 12 kg, and 2.4 mm in the 15 kg group. The visual analogue scale averaged 84, 83, and 79 mm, respectively. There were no significant differences among the three groups. There were also no significant differences between the groups for muscle strength recovery during isokinetic and isometric contraction at 1 year postoperatively.


There were no significant differences among the groups in subjective clinical results, anterior laxity, and knee extensor strength in the ACL reconstructions that used the autogenous semitendinosus tendon graft.

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