Anterior Cruciate Ligament (ACL) Tears: Technique for Hamstring Graft Harvest

Anterior Cruciate Ligament (ACL) Tears: Technique for Hamstring Graft Harvest

This video is a cadaveric demonstration of a hamstring graft harvesting used in ACL reconstruction. The hamstrings are a group of three muscles located at the back of the thigh that work together.

A hamstring graft is typically taken from the tendon of only one of the hamstring muscles, called the semitendinosus, without affecting the other two muscles. Only in certain cases might the surgeon need to use two of these tendons.

Here we have a right knee, with the inner side of the knee facing the screen. The surgeon will begin by feeling along the inner side of the knee and marking where the incision will be made. Sometimes the incision will be made along the front of the shin bone here. In this video, the incision will be made along the back of the knee, here. The tendon can be harvested from either location.

Next, the surgeon uses a scalpel to cut through the skin and soft tissue to expose the hamstring tendon. Once the tendon is identified, the surgeon will loop a suture around the tendon.

Next, a specialized instrument, called a hamstring harvester, is closed around the tendon. The surgeon slides the hamstring harvester all the way up the length of the tendon, and slowly pushes to strip the tendon away from the muscle.

Next, the surgeon passes the free end of the tendon through another harvesting instrument. The surgeon slides the instrument all the way down the length of the tendon and cuts the tendon off from where it attaches to the shin bone. This tendon is then prepared with sutures so it can be used as the patient's new ACL.