Morphology of proximal and distal human semitendinosus compartments and the effects of distal tendon harvesting for anterior cruciate ligament reconstruction

Adam Kositsky*, Huub Maas, Rod S. Barrett, Ben Kennedy, Lauri Stenroth, Rami K. Korhonen, Christopher J. Vertullo, Laura E. Diamond, David J. Saxby

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

The human semitendinosus muscle is characterized by a tendinous inscription separating proximal and distal neuromuscular compartments. As each compartment is innervated by separate nerve branches, potential exists for independent operation and control of compartments. However, the morphology and function of each compartment have not been thoroughly examined in an adult human population. Further, the distal semitendinosus tendon is typically harvested for use in anterior cruciate ligament reconstruction surgery, which induces long-term morphological changes to the semitendinosus muscle-tendon unit. It remains unknown if muscle morphological alterations following anterior cruciate ligament reconstruction are uniform between proximal and distal semitendinosus compartments. Here, we performed magnetic resonance imaging on 10 individuals who had undergone anterior cruciate ligament reconstruction involving an ipsilateral distal semitendinosus tendon graft 14 ± 4 months prior, extracting morphological parameters of the whole semitendinosus muscle and each individual compartment from both the (non-injured) contralateral and surgical legs. In the contralateral leg, volume and length of the proximal compartment were smaller than the distal compartment. No between-compartment differences in volume or length were found for anterior cruciate ligament reconstructed legs, likely due to greater shortening of the distal compared to the proximal compartment after anterior cruciate ligament reconstruction. The maximal anatomical cross-sectional area of both compartments was substantially smaller on the anterior cruciate ligament reconstructed leg but did not differ between compartments on either leg. The absolute and relative between-leg differences in proximal compartment morphology on the anterior cruciate ligament reconstructed leg were strongly correlated with the corresponding between-leg differences in distal compartment morphological parameters. Specifically, greater between-leg morphological differences in one compartment were highly correlated with large between-leg differences in the other compartment, and vice versa for smaller differences. These relationships indicate that despite the heterogeneity in compartment length and volume, compartment atrophy is not independent or random. Further, the tendinous inscription endpoints were generally positioned at the same proximodistal level as the compartment maximal anatomical cross-sectional areas, providing a wide area over which the tendinous inscription could mechanically interact with compartments. Overall, results suggest the two human semitendinosus compartments are not mechanically independent.

Original languageEnglish
Pages (from-to)297-310
Number of pages14
JournalJournal of Anatomy
Volume243
Issue number2
Early online date13 Apr 2023
DOIs
Publication statusPublished - Aug 2023

Bibliographical note

Funding Information:
The authors would like to thank Mr. William du Moulin and the staff at QSCAN Radiology, Parkwood for their assistance in data acquisition. This work was supported in part by a Griffith University Postgraduate Research Scholarship (to AK), the Erasmus+ Progamme of the European Union (to AK and LS), and the Academy of Finland (#324529 to RKK, #332915 to LS). Open access publishing facilitated by Griffith University, as part of the Wiley - Griffith University agreement via the Council of Australian University Librarians.

Funding Information:
The authors would like to thank Mr. William du Moulin and the staff at QSCAN Radiology, Parkwood for their assistance in data acquisition. This work was supported in part by a Griffith University Postgraduate Research Scholarship (to AK), the Erasmus+ Progamme of the European Union (to AK and LS), and the Academy of Finland (#324529 to RKK, #332915 to LS). Open access publishing facilitated by Griffith University, as part of the Wiley ‐ Griffith University agreement via the Council of Australian University Librarians.

Publisher Copyright:
© 2023 The Authors. Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.

Funding

The authors would like to thank Mr. William du Moulin and the staff at QSCAN Radiology, Parkwood for their assistance in data acquisition. This work was supported in part by a Griffith University Postgraduate Research Scholarship (to AK), the Erasmus+ Progamme of the European Union (to AK and LS), and the Academy of Finland (#324529 to RKK, #332915 to LS). Open access publishing facilitated by Griffith University, as part of the Wiley - Griffith University agreement via the Council of Australian University Librarians. The authors would like to thank Mr. William du Moulin and the staff at QSCAN Radiology, Parkwood for their assistance in data acquisition. This work was supported in part by a Griffith University Postgraduate Research Scholarship (to AK), the Erasmus+ Progamme of the European Union (to AK and LS), and the Academy of Finland (#324529 to RKK, #332915 to LS). Open access publishing facilitated by Griffith University, as part of the Wiley ‐ Griffith University agreement via the Council of Australian University Librarians.

Keywords

  • graft
  • hamstrings
  • magnetic resonance imaging
  • tendinous inscription
  • tenotomy

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