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Purpose <p>The semitendinosus tendon (STT) remains one of the principal autografts in knee ligament reconstruction; however, anatomical variations may significantly influence surgical practice. Among these, the accessory band of the semitendinosus tendon (aSTT) has attracted attention because of its potential to complicate graft harvesting, increase the risk of misidentification, and even lead to a change in graft selection or inadvertent transection of the ST tendon. Current reports on the morphology and prevalence of the aSTT are inconsistent, largely due to heterogeneous definitions. This study aimed to systematically synthesize available anatomical evidence on the prevalence, morphology, and fascial connections of the accessory semitendinosus tendon.</p> Methods <p>A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Eighteen cadaveric studies comprising 839 knees were included. Qualitative and quantitative data were synthesised using MetaXL 5.3 and Comprehensive Meta-Analysis 4 with a random-effects model. Statistical heterogeneity was assessed using Chi² and I² statistics.</p> Results <p>The pooled prevalence of the aSTT was 72.2% (95% CI: 59.4–82.2%), with marked regional variation. Prevalence was highest in Europe (91.0%; 95% CI: 60.7–100%), followed by North America (62.4%; 95% CI: 0-100%), and Asia (55.5.2%; 95% CI: 28.9–79.3%). Across studies, the aSTT demonstrated consistent morphometric patterns and characteristic fascial connections.</p> Conclusions <p>The accessory semitendinosus tendon represents a frequent anatomical variant with clear regional variability. Awareness of this structure is essential during semitendinosus tendon harvesting for ligament reconstruction, as its presence may influence graft identification, preparation, and surgical planning.</p>

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Morphology of the accessory band of the semitendinosus tendon (aSTT): meta-analysis and systematic review

  • 期刊论文

  • 发表日期：

    2026年3月13日

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  • Kamil Możdżeń,
  • Grzegorz Fibiger,
  • Michał Malczak,
  • Jonasz Tempski,
  • Konrad Malinowski,
  • Kacper Stolarz,
  • Dominik Łazarz,
  • Agnieszka Murawska,
  • Tomasz Kozioł,
  • Jerzy Andrzej Walocha,
  • Przemysław Pękala

摘要

Purpose

The semitendinosus tendon (STT) remains one of the principal autografts in knee ligament reconstruction; however, anatomical variations may significantly influence surgical practice. Among these, the accessory band of the semitendinosus tendon (aSTT) has attracted attention because of its potential to complicate graft harvesting, increase the risk of misidentification, and even lead to a change in graft selection or inadvertent transection of the ST tendon. Current reports on the morphology and prevalence of the aSTT are inconsistent, largely due to heterogeneous definitions. This study aimed to systematically synthesize available anatomical evidence on the prevalence, morphology, and fascial connections of the accessory semitendinosus tendon.

Methods

A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. Eighteen cadaveric studies comprising 839 knees were included. Qualitative and quantitative data were synthesised using MetaXL 5.3 and Comprehensive Meta-Analysis 4 with a random-effects model. Statistical heterogeneity was assessed using Chi² and I² statistics.

Results

The pooled prevalence of the aSTT was 72.2% (95% CI: 59.4–82.2%), with marked regional variation. Prevalence was highest in Europe (91.0%; 95% CI: 60.7–100%), followed by North America (62.4%; 95% CI: 0-100%), and Asia (55.5.2%; 95% CI: 28.9–79.3%). Across studies, the aSTT demonstrated consistent morphometric patterns and characteristic fascial connections.

Conclusions

The accessory semitendinosus tendon represents a frequent anatomical variant with clear regional variability. Awareness of this structure is essential during semitendinosus tendon harvesting for ligament reconstruction, as its presence may influence graft identification, preparation, and surgical planning.