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The ‘sentinel’ vessel: an anatomical landmark to identify the pes anserinus during hamstrings harvest for ACL reconstruction

  • Satish BabuEmail author
  • Chinmay Gupte
  • Shreyash Gajjar
  • Hayden Morris
Original Article • KNEE - ARTHROSCOPY
  • 33 Downloads

Abstract

Hamstrings identification and subsequent graft harvest can be made difficult by body habitus and variability in tendon anatomy. We describe a ‘sentinel’ blood vessel near the insertions of gracilis and semitendinosus to facilitate identification. A prospective study of 100 patients (100 knees) undergoing primary arthroscopic ACL reconstruction (via the anterior approach) with hamstrings graft was conducted. We searched for a ‘sentinel’ vessel and studied its position, orientation and perpendicular distance from the pes tendons. The ‘sentinel’ vessel was present in 98/100 knees. It passed from the superficial fascia to the periosteum at the pes insertion at a mean perpendicular distance of 8 mm from the upper border of the pes tendons. The ‘sentinel’ vessel was a consistent anatomical finding and served as a reliable guide in determining the pes insertion. Identifying this anatomical landmark allowed a small skin incision with limited wound dissection minimising risk of injury to the infra-patellar branch of the saphenous nerve.

Keywords

Sentinel blood vessel ACL Pes anserinus Hamstrings Graft Morbidity 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest related to the publication of this manuscript.

Informed consent

The study was authorised by the local ethical committee and was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki as revised in 2000.

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Frimley Park HospitalFrimleyUK
  2. 2.Imperial College Healthcare NHS TrustLondonUK
  3. 3.Kokilaben Dhirubhai Ambani HospitalMumbaiIndia
  4. 4.St. Vincent’s & Mercy HospitalsMelbourneAustralia

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