Shear-Wave Elastography of Regenerated Hamstring Tendons After ACL Reconstruction (SWE-ACL)

NCT07555782 | Active Not Recruiting

• 1 other identifier: SWE-ACL-2026
• Study Type: observational
• Target: 29
• Locations: 1 country
• Sites: 1

Brief Summary

Anterior cruciate ligament (ACL) reconstruction using autologous hamstring tendon grafts is a commonly performed procedure. Although the semitendinosus and gracilis tendons demonstrate regeneration at the donor site, the structural and biomechanical properties of the regenerated tissue may differ from native tendon, potentially affecting muscle function. This study aims to quantitatively assess the elasticity of regenerated hamstring tendons using shear-wave elastography (SWE) and to compare these measurements with the contralateral intact side. Additionally, the relationship between tendon elasticity and isokinetic hamstring muscle strength will be evaluated. Secondary objectives include investigating the association between elastography findings and functional clinical outcomes, as well as the effect of postoperative time and patient-related factors such as age and body mass index.

Conditions

Muscle Weakness; Anterior Cruciate Ligament Rupture; Tendon Injuries

Keywords

Anterior Cruciate Ligament Reconstruction; Hamstring Tendon; Shear-Wave Elastography; Isokinetic Strength; Functional Outcomes

Outcome Measures

Primary Outcomes (1)

• Elasticity of Regenerated Hamstring Tendons Measured by Shear-Wave Elastography

  Quantitative assessment of the elasticity of regenerated semitendinosus and gracilis tendons using shear-wave elastography (SWE). Elasticity will be measured as Young's modulus (kilopascals, kPa) or shear-wave velocity (meters per second, m/s). Measurements will be obtained from the operated limb and compared with the contralateral intact side.

  At a single postoperative assessment (≥6 months after surgery)

Secondary Outcomes (8)

• Isokinetic Hamstring Muscle Strength

  At a single postoperative assessment (≥6 months after surgery)

• International Knee Documentation Committee (IKDC) Score

  At a single postoperative assessment (≥6 months after surgery)

• Lysholm Knee Score

  At a single postoperative assessment (≥6 months after surgery)

• Tegner Activity Scale

  At a single postoperative assessment (≥6 months after surgery)

• Graft Characteristics on MRI

  MRI obtained during postoperative follow-up (≥6 months)

Study Arms (1)

ACL Reconstruction With Hamstring Autograft

Patients who have undergone anterior cruciate ligament (ACL) reconstruction using autologous hamstring tendon grafts (semitendinosus and gracilis) and have completed at least 6 months of postoperative follow-up will be included. Participants will undergo shear-wave elastography (SWE) assessment of regenerated hamstring tendons. Previously obtained magnetic resonance imaging (MRI) and isokinetic muscle strength (Cybex) measurements will be collected from institutional records. Elastography measurements will be compared with the contralateral intact side, and associations with muscle strength, imaging findings, and functional clinical outcomes will be analyzed.

Other: Shear-Wave Elastography Assessment

Interventions

Shear-Wave Elastography Assessment OTHER

Shear-Wave elastography (SWE) will be used to quantitatively assess the elasticity of regenerated hamstring tendons. Measurement will be obtained in kilopascal (kPa) or meters per second (m/s) and compared with the contralateral intact side. These values will be analyzed in relation to isokinetic muscle strength and clinical outcomes.

Also known as: SWE, Elastography

ACL Reconstruction With Hamstring Autograft

Eligibility Criteria

• Age: 18 Years - 50 Years
• Sex: all
• Age Groups: Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of adult patients who have undergone anterior cruciate ligament (ACL) reconstruction using autologous hamstring tendon grafts (semitendinosus and gracilis) and have completed at least 6 months of postoperative follow-up. Participants will be selected from a single tertiary referral center and will have available postoperative magnetic resonance imaging (MRI) and isokinetic muscle strength (Cybex) data. All eligible patients will undergo shear-wave elastography (SWE) assessment of the regenerated hamstring tendons at the time of study enrollment.

You may qualify if:

• Patients who have undergone anterior cruciate ligament (ACL) reconstruction using autologous hamstring tendon grafts (semitendinosus and gracilis)
• At least 6 months of postoperative follow-up
• Availability of postoperative magnetic resonance imaging (MRI) and isokinetic muscle strength (Cybex) measurements
• Willingness to participate and provide informed consent

You may not qualify if:

• History of previous surgery on the same lower extremity (other than the index ACL reconstruction)
• Presence of neuromuscular disorders affecting lower extremity function
• Incomplete clinical, imaging, or functional data
• Inability to undergo elastography assessment

Sponsors & Collaborators

• Fatih Sultan Mehmet Training and Research Hospital: lead

Study Sites (1)

Fatih Sultan Mehmet Training and Research Hospital

Ataşehir, Istanbul, 34752, Turkey (Türkiye)

Location

Related Publications (4)

• Alp NB, Akdag G, Kaleli T, Macunluoglu AC, Uzunlulu N. Evaluation of patellar tendon with shear wave elastography after anterior cruciate ligament reconstruction using hamstring tendons. Jt Dis Relat Surg. 2020;31(1):137-42. doi: 10.5606/ehc.2020.71745.

  PMID: 32160507 BACKGROUND

• Pasurka M, Falck T, Kubach J, Simon M, Sollner S, Strobel D, Perl M, Betsch M. Comparison of In Vivo Stiffness of Tendons Commonly Used for Anterior Cruciate Ligament Reconstruction - A Shear Wave Elastography Study. Acad Radiol. 2024 Aug;31(8):3297-3305. doi: 10.1016/j.acra.2024.01.037. Epub 2024 Feb 19.

  PMID: 38378326 BACKGROUND

• Panagopoulos A, Giannatos V, Moros G, Mylonas D, Kouzelis A, Gliatis J. Isokinetic Muscle Strength and Knee Function in Anatomical Anterior Cruciate Ligament Reconstruction With Hamstring Autografts: A Prospective Randomized Comparative Study Between Suspensory and Expandable Femoral Fixation in Male Patients. Cureus. 2022 Dec 13;14(12):e32482. doi: 10.7759/cureus.32482. eCollection 2022 Dec.

  PMID: 36644094 BACKGROUND

• Grasso S, Linklater J, Li Q, Parker DA. Validation of an MRI Protocol for Routine Quantitative Assessment of Tunnel Position in Anterior Cruciate Ligament Reconstruction. Am J Sports Med. 2018 Jun;46(7):1624-1631. doi: 10.1177/0363546518758950. Epub 2018 Mar 28.

  PMID: 29589954 BACKGROUND

MeSH Terms

Conditions

Anterior Cruciate Ligament Injuries; Tendon Injuries; Muscle Weakness

Condition Hierarchy (Ancestors)

Knee Injuries; Leg Injuries; Wounds and Injuries; Muscular Diseases; Musculoskeletal Diseases; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MD, Orthopedic Surgery Resident, Research Fellow

Study Record Dates

• First Submitted: April 21, 2026
• First Posted: April 29, 2026
• Study Start: March 30, 2025
• Primary Completion: March 30, 2026
• Study Completion: April 30, 2026
• Last Updated: April 29, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)