Natural history of a hamstring tendon autograft used for anterior cruciate ligament reconstruction in a sheep model

The purpose of this study was to describe the histologic structure of the intraarticular segment of a semitendinosus tendon autograft used for anterior cruciate ligament reconstruction over the first year after surgery. We performed an anterior cruciate ligament reconstruction in a single hindlimb of 11 sheep using a doubled semitendinosus tendon autograft secured to the femur with an endoscopic button and polyester tape and to the tibia with sutures tied around a screw. The histologic structure of the intraarticular segment of the graft at 4, 8, 12, 24, and 52 weeks after surgery was compared with that of the normal semitendinosus tendon and anterior cruciate ligament. The random collagen fiber orientation progressed to a longitudinal orientation from the peripheral to the central areas of the graft over the initial 12 weeks after surgery. A uniform sinusoidal crimp pattern similar to that seen in the normal anterior cruciate ligament was identified under polarized light in nearly one-half of each graft by 24 weeks. Further maturation was noted at 52 weeks. Graft necrosis was not evident at any time period. This study showed that semitendinosus tendon autografts transform into a histologic structure similar to that of the normal anterior cruciate ligament over the initial year after surgery, as has been described for patellar tendon grafts.