J Korean Orthop Assoc.  2012 Aug;47(4):277-285. 10.4055/jkoa.2012.47.4.277.

Flexor Weakness and Clinical Outcomes after Hamstring Harvest in Anterior Cruciate Ligament Reconstruction: Comparison of Single- and Double-Tendon Harvesting Techniques

  • 1Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University, Seoul, Korea. boram107@hanmail.net
  • 2Department of Orthopedic Surgery, Sarang Hospital, Incheon, Korea.


To compare of the flexion weakness and clinical outcomes of patients who underwent an anterior cruciate ligament (ACL) reconstruction between semitendinosus (ST) group and semitendinosus and gracilis (ST & G) group.
The patients who underwent ACL reconstruction by autologous hamstring tendon and were followed up for more than 2 years; for more than 2 years were studied. We excluded females; Thus, 41 of ST group and 30 of ST & G group, retrospectively, were evaluated. Outcomes were assessed by the Lysholm knee score, Tegner activity score, KT-2000 side-to-side difference and functional performance tests. The flexion deficit and isokinetic peak torque for knee flexion were measured in the sitting position, and the flexion torque at deep flexion was measured in the prone position using a Biodex System III dynamometer.
No statistically significant differences were observed between the two groups in terms of clinical and functional performance tests. In operated limb, significant knee flexion weakness at the isokinetic peak torque for knee flexion was observed, but no statistically significant differences were found between the two groups. Especially, a significantly smaller deep knee flexion deficit was observed in the ST group than in the ST & G group (p<0.01).
After ACL reconstruction by hamstring autograft, a greater knee flexion weakness was observed. Especially a significantly greater deep knee flexion deficit was observed in the ST & G group than in the ST group.


hamstring; semitendinosus; gracilis; flexion deficit; anterior cruciate ligament reconstruction

MeSH Terms

Anterior Cruciate Ligament
Anterior Cruciate Ligament Reconstruction
Prone Position
Retrospective Studies


  • Figure 1 A graft harvest technique. (A) Reversed 'L'-shape incision to the sartorius fascia. (B) Harvest of semitendi nosus tendon.

  • Figure 2 (A) Standard isokinetic testing. (B) Hyperflexion isokinetic testing.


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