Electron microscopy of the remodelling process in hamstring tendon used as ACL graft

Stefano Zaffagnini, Viviana de Pasquale, Leonardo Marchesini Reggiani, Alessandro Russo, Patrizia Agati, Beatrice Bacchelli, Maurilio Marcacci

Research output: Contribution to journalArticlepeer-review


The purpose of the present study was to make a histological analysis of the remodelling process of hamstring tendon graft used as Anterior Cruciate Ligament (ACL). The hamstring graft of eight patients was biopsied at different follow-up times from 1 to 10 years. The specimens were analysed with transmission electron microscopy (TEM) at ultrastructural level comparing them with a native ACL and a native hamstring graft. The hamstring graft was found to undergo ultrastructural changes in terms of number and diameter of fibrils with the major changes occurring in the first 2 years. At longer times after surgery (48 and 120 months) no important further changes were evident and the ultrastructure did not vary substantially from 2 to 10 years. In conclusion, the hamstring tendon used as ACL graft undergoes a transformation process but does not match the ultrastructure pattern of a normal ACL up to 10 years.

Original languageEnglish
Pages (from-to)1052-1058
Number of pages7
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Issue number8
Publication statusPublished - 2010


  • ACL reconstruction
  • Arthroscopy
  • Electron microscopy
  • Hamstring
  • Knee

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery


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