Hamstring autograft utilization in reconstructing anterior cruciate ligament: Review of harvesting techniques, graft preparation, and different fixation methods

doi:10.5312/wjo.v13.i10.876

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World Journal of Orthopedics

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World J Orthop. Oct 18, 2022; 13(10): 876-890
Published online Oct 18, 2022. doi: 10.5312/wjo.v13.i10.876

Hamstring autograft utilization in reconstructing anterior cruciate ligament: Review of harvesting techniques, graft preparation, and different fixation methods

Waleed Albishi, Baraa Baltow, Nora Albusayes, Ameer A Sayed, Hamza M Alrabai

Waleed Albishi, Nora Albusayes, Hamza M Alrabai, Department of Orthopedic Surgery, College of Medicine, King Saud University, Riyadh 11362, Saudi Arabia

Baraa Baltow, Department of Orthopedic Surgery, AlHada Armed Forces Hospital, Ministry of Defense, AlHada 26792, Saudi Arabia

Ameer A Sayed, Department of Orthopedic Surgery, King Fahad Armed Forces Hospital, Ministry of Defense, Jeddah 23311, Saudi Arabia

Author contributions: Albishi W devised the project, main conceptual ideas, and proof outline; Baltow B, Albusayes N, and Sayed AA retrieved articles from the database and examined for relevance; Albishi W, Albusayes N, and Sayed AA wrote the manuscript in consultation with Baltow B and Arabai HM.

Conflict-of-interest statement: The authors declare no conflicts of interest.

Corresponding author: Nora Albusayes, MBBS, Doctor, Staff Physician, Department of Orthopedic Surgery, College of Medicine, King Saud University, 7804 Street No. 18, Riyadh 11362, Saudi Arabia. nalbusayes@gmail.com

Received: May 14, 2022
Peer-review started: May 14, 2022
First decision: June 16, 2022
Revised: July 16, 2022
Accepted: August 15, 2022
Article in press: August 15, 2022
Published online: October 18, 2022
Processing time: 155 Days and 13.7 Hours

Abstract

Rupture of the anterior cruciate ligament (ACL) is a common orthopedic injury. Various graft options are available for the reconstruction of ruptured ACL. Using the hamstring muscle as an autograft was first described in 1934, and it remains a commonly harvested graft for ACL reconstruction. Hamstring autografts can be harvested using the traditional anteromedial approach or the newer posteromedial technique. An isolated semitendinosus tendon can be used or combined with the gracilis tendon. There are numerous methods for graft fixation, such as intra-tunnel or extra-tunnel fixation. This comprehensive review discusses the different hamstring muscle harvesting techniques and graft preparation options and fixation methods. It provides a comprehensive overview for choosing the optimal surgical technique when treating patients.

Keywords: Anterior cruciate ligament; Anterior cruciate ligament reconstruction; Graft fixation; Hamstring autograft; Infrapatellar nerve injury; Patient reported outcomes

Core tip: Anterior cruciate ligament (ACL) rupture is a common orthopedic injury and various graft options are available for the reconstruction of a ruptured ACL. This comprehensive review discusses the different hamstring muscle harvesting techniques as well as graft preparation and fixation methods that can be used to guide clinicians in making evidence-based decisions when treating their patients.