Skip to main content
SpringerLink
Log in

Graft Harvest and Preparation

  • Chapter
  • First Online:
Anterior Cruciate Ligament Reconstruction

  • 2820 Accesses

Abstract

In this chapter, a systematic and reproducible minimally invasive hamstring harvesting technique is presented. Additionally, due to small diameters that are sometimes obtained after the tendons are doubled as usual for a quadruple hamstring graft, a technique to triplicate the harvested tendons is also shown.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Chen CH, Chuang TY, Wang KC et al (2006) Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon autograft: clinical outcome in 4–7 years. Knee Surg Sports Traumatol Arthrosc 14:1077–1085

    Article  CAS  PubMed  Google Scholar 

  2. Eriksson E (2007) Patellar tendon or quadriceps tendon grafts for ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 15:1283

    Article  PubMed  Google Scholar 

  3. Eriksson K, Hamberg P, Jansson E et al (2001) Semitendinosus muscle in anterior cruciate ligament surgery: morphology and function. Arthroscopy 17:808–817

    Article  CAS  PubMed  Google Scholar 

  4. Erquicia J, Gelber PE, Doreste JL et al (2013) How to improve the prediction of quadruple semitendinosus and gracilis autograft sizes with magnetic resonance imaging and ultrasonography. Am J Sports Med 41:1857–1863

    Article  PubMed  Google Scholar 

  5. Fink C, Hoser C (2013) Einzelbündeltechnik: Quadrizepssehne in Portaltechnik. Arthroskopie 26:35–41

    Article  Google Scholar 

  6. Garofalo R, Djahangiri A, Siegrist O (2006) Revision anterior cruciate ligament reconstruction with quadriceps tendon-patellar bone autograft. Arthroscopy 22:205–214

    Article  PubMed  Google Scholar 

  7. Geib TM, Shelton WR, Phelps RA et al (2009) Anterior cruciate ligament reconstruction using quadriceps tendon autograft: intermediate-term outcome. Arthroscopy 25:1408–1414

    Article  PubMed  Google Scholar 

  8. Gorschewsky O, Klakow A, Putz A et al (2007) Clinical comparison of the autologous quadriceps tendon (BQT) and the autologous patella tendon (BPTB) for the reconstruction of the anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 15:1284–1292

    Article  CAS  PubMed  Google Scholar 

  9. Grood ES, Walz-Hasselfeld KA, Holden JP et al (1992) The correlation between anterior-posterior translation and cross-sectional area of anterior cruciate ligament reconstructions. J Orthop Res 10:878–885

    Article  CAS  PubMed  Google Scholar 

  10. Guillard C, Lintz F, Odri GA et al (2012) Effects of graft pretensioning in anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 20:2208–2213

    Article  PubMed  Google Scholar 

  11. Hamner DL, Brown CH Jr, Steiner ME et al (1999) Hamstring tendon grafts for reconstruction of the anterior cruciate ligament: biomechanical evaluation of the use of multiple strands and tensioning techniques. J Bone Joint Surg Am 81:549–557

    CAS  PubMed  Google Scholar 

  12. Hoeher J, Balke M, Albers M et al (2012) Anterior cruciate ligament (ACL) reconstruction using a quadriceps tendon autograft and press-fit fixation has equivalent results compared to a standard technique using semitendinosus graft: a prospective matched-pair analysis after 1 year. Knee Surg Sports Traumatol Arthrosc 20:147

    Article  Google Scholar 

  13. Judd D, Bottoni C, Kim D et al (2006) Infections following arthroscopic anterior cruciate ligament reconstruction. Arthroscopy 22:375–384

    Article  PubMed  Google Scholar 

  14. Kartus J, Movin T, Karlsson J (2001) Donor-site morbidity and anterior knee problems after anterior cruciate ligament reconstruction using autografts. Arthroscopy 17:971–980

    Article  CAS  PubMed  Google Scholar 

  15. Kerimoğlu S, Aynaci O, Saraçoğlu M, Aydin H, Turhan AU (2008) Anterior cruciate ligament reconstruction with the peroneus longus tendon. Acta Orthop Traumatol Turc 42:38–43

    Article  PubMed  Google Scholar 

  16. Kim SJ, Kumar P, Oh KS (2009) Anterior cruciate ligament reconstruction: autogenous quadriceps tendon-bone compared with bone-patellar tendon-bone grafts at 2-year follow-up. Arthroscopy 25:137–144

    Article  PubMed  Google Scholar 

  17. Lee S, Seong SC, Jo H et al (2004) Outcome of anterior cruciate ligament reconstruction using quadriceps tendon autograft. Arthroscopy 20:795–802

    Article  PubMed  Google Scholar 

  18. Ma CB, Keifa E, Dunn W et al (2010) Can pre-operative measures predict quadruple hamstring graft diameter? Knee 17:81–83

    Article  PubMed  Google Scholar 

  19. Maeda E, Asanuma H, Noguchi H et al (2009) Effects of stress shielding and subsequent restressing on mechanical properties of regenerated and residual tissues in rabbit patellar tendon after resection of its central one-third. J Biomech 42:1592–1597

    Article  PubMed  Google Scholar 

  20. Mochizuki T, Akita K, Muneta T et al (2003) Anatomical bases for minimizing sensory disturbance after arthroscopically-assisted anterior cruciate ligament reconstruction using medial hamstring tendons. Surg Radiol Anat 25:192–199

    Article  CAS  PubMed  Google Scholar 

  21. Mochizuki T, Muneta T, Yagishita K et al (2004) Skin sensory change after arthroscopically-assisted anterior cruciate ligament reconstruction using medial hamstring tendons with a vertical incision. Knee Surg Sports Traumatol Arthrosc 2:198–202

    Google Scholar 

  22. Noyes FR, Butler DL, Grood ES et al (1984) Biomechanical analysis of human ligament grafts used in knee-ligament repairs and reconstructions. J Bone Joint Surg 66:344–352

    CAS  PubMed  Google Scholar 

  23. Pagnani MJ, Warner JJP, O’Brien SJ et al (1993) Anatomic considerations in harvesting the semitendinosus and gracilis tendons and a technique of harvest. Am J Sports Med 21:565–571

    Article  CAS  PubMed  Google Scholar 

  24. Papastergiou SG, Voulgaropoulos H, Mikalef P et al (2006) Injuries to the infrapatellar branch(es) of the saphenous nerve in anterior cruciate ligament reconstruction with four-strand hamstring tendon autograft: vertical versus horizontal incision for harvest. Knee Surg Sports Traumatol Arthrosc 14:789–793

    Article  PubMed  Google Scholar 

  25. Petri M, Ettinger M, Drtzidis A et al (2012) Comparison of three suture techniques and three suture materials on gap formation and failure load in ruptured tendons: a human cadaveric study. Arch Orthop Trauma Surg 132:649–654

    CAS  PubMed  Google Scholar 

  26. Rosenberg TD, Deffner KT (1997) ACL reconstruction: semitendinosus tendon is the graft of choice. Orthopedics 20:396–398

    CAS  PubMed  Google Scholar 

  27. Sabat D, Kumar V (2012) Nerve injury during hamstring graft harvest: a prospective comparative study of three different incisions. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-012-2243-8

    PubMed  Google Scholar 

  28. Sanders B, Rolf R, McClelland W et al (2007) Prevalence of saphenous nerve injury after autogenous hamstring harvest: an anatomical and clinical study of sartorial branch injury. Arthroscopy 23:956–963

    Article  PubMed  Google Scholar 

  29. Shaieb MD, Kan DM, Chang SK et al (2002) A prospective randomized comparison of patellar tendon versus semitendinosus and gracilis tendon autografts for anterior cruciate ligament reconstruction. Am J Sports Med 30:214–220

    PubMed  Google Scholar 

  30. Snow M, Cheung W, Mahmud J (2012) Mechanical assessment of two different methods of tripling hamstring tendons when using suspensory fixation. Knee Surg Sports Traumatol Arthrosc 20:262–267

    Article  PubMed  Google Scholar 

  31. Solman CG Jr, Pagnani MJ (2003) Hamstring tendon harvesting. Reviewing anatomic relationships and avoiding pitfalls. Orthop Clin North Am 34:1–8

    Article  PubMed  Google Scholar 

  32. Stäubli H, Bollmann C, Kreutz R et al (1999) Quantification of intact quadriceps tendon, quadriceps tendon insertion, and suprapatellar fat pad: MR arthrography, anatomy, and cryosections in the sagittal plane. Am J Roentgenol 173:691–698

    Article  Google Scholar 

  33. Stäubli H, Schatzmann L, Brunner P et al (1999) Mechanical tensile properties of the quadriceps tendon and patellar ligament in young adults. Am J Sports Med 27:27–34

    PubMed  Google Scholar 

  34. Tashiro T, Kurosawa H, Kawakami A et al (2003) Influence of medial hamstring tendon harvest on knee flexor strength after anterior cruciate ligament reconstruction. Am J Sports Med 31:522–529

    Article  PubMed  Google Scholar 

  35. Tillet E, Madsen R, Rogers R et al (2004) Localization of the semitendinosus-gracilis tendon bifurcation point relative to the tibial tuberosity: an aid to hamstring tendon harvest. Arthroscopy 20:51–54

    Article  Google Scholar 

  36. Vertullo CJ, Quick M, Jones A et al (2012) A surgical technique using presoaked vancomycin hamstring graft to decrease the risk of infection after anterior cruciate ligament reconstruction. Arthroscopy 28:337–342

    Article  PubMed  Google Scholar 

  37. Wang JH (2006) Mechanobiology of tendon. J Biomech 39:1563–1582

    Article  PubMed  Google Scholar 

  38. Zhao J, Huangfu X (2012) The biomechanical and clinical application of using the anterior half of the peroneus longus tendon as an autograft source. Am J Sports Med 40:662–671

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital de Sant Pau, Universitat Autònoma de Barcelona, C/Sant Quintí 89, Barcelona, 08041, Spain

    Juan Carlos Monllau MD, PhD

  2. Department of Orthopaedic and Trauma Surgery, Martin Luther Hospital, Berlin Grunewald, Caspar Theyss Strasse 27-34, Berlin, D-14193, Germany

    Wolf Petersen

  3. OSM Research Foundation, Sportsclinic Austria, Olympiastr. 39, Innsbruck, 6020, Austria

    Christian Fink & Christian Hoser

  4. Department of Orthopaedic Surgery and Traumatology, COPV – Chirurgisch Orthopädischer PraxisVerbund, Breitenbachplatz 8, 14195, Berlin, Germany

    Sven U. Scheffler

  5. Catalan Institute of Traumatology and Sports Medicine (ICATME). Hospital Universitari Quirón Dexeus, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain

    Pablo Eduardo Gelber MD, PhD

Authors
  1. Juan Carlos Monllau MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wolf Petersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Christian Fink
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sven U. Scheffler
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pablo Eduardo Gelber MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Christian Hoser
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Juan Carlos Monllau MD, PhD , Wolf Petersen , Christian Fink or Sven U. Scheffler .

Editor information

Editors and Affiliations

  1. ATOS Hospital Heidelberg, Heidelberg, Germany

    Rainer Siebold

  2. Lyon Ortho Clinic, Lyon, France

    David Dejour

  3. Istituti Ortopedico Rizzoli Clinica Ortopedica Traumatologica III, Bologna, Italy

    Stefano Zaffagnini

Rights and permissions

Reprints and permissions

Copyright information

© 2014 ESSKA

About this chapter

Cite this chapter

Monllau, J.C., Petersen, W., Fink, C., Scheffler, S.U., Gelber, P.E., Hoser, C. (2014). Graft Harvest and Preparation. In: Siebold, R., Dejour, D., Zaffagnini, S. (eds) Anterior Cruciate Ligament Reconstruction. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45349-6_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-45349-6_17

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-45348-9

  • Online ISBN: 978-3-642-45349-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation