Summary

Examines the length of the hamstring graft produced by the posterior harvest technique during MPFL reconstruction.

Abstract

Introduction

Anterior harvesting of the hamstring tendon has been the most frequently used approach to obtain a hamstring autograft in ACL and MPFL reconstructions. However, a posterior technique is another option for a hamstring harvest that results in a smaller scar and improved cosmesis. The aim of this study is to examine the length of the hamstring graft produced by the posterior harvest technique.

Methods

For all MPFL reconstructions that required a hamstring autograft, the hamstring graft length was measured immediately after harvest. The length of the tendon was measured with a sterile ruler after stripping off all muscle in addition to the maximal length of the incision. The amount of time the tourniquet was applied until the graft was harvested was recorded. It was noted if the tendon was gracilis or semitendinosus and if a tibial tubercle osteotomy was performed. Demographic information including age, gender, height, and BMI were also collected at the time of surgery.

Results

Data was prospectively collected on a consecutive series of 68 MPFL reconstructions. All 68 hamstring autografts were harvested using the posterior approach. The average graft length for the semitendinosus (n=52) and gracilis (n=16) tendons were 27.4 cm and 27.1 cm, respectively. The average incision length for the posterior group was 2.1 cm. The average tourniquet time to harvest was 6.9 minutes. None of the harvests were unsuccessful or required an autograft from another source or an allograft.

Conclusion

Although the anterior harvesting technique is more common, this study demonstrates that the posterior technique produces grafts of sufficient length for MPFL reconstruction while requiring a smaller incision. This may improve patient satisfaction with his or her scar while maintaining graft integrity.