Comparison of medial hamstring length between harvesting methods using anterior and posterior approaches

Abstract

<p>BACKGROUND</p><p>Medial hamstring harvesting can be performed either through an anterior approach or a posterior approach. It has been suggested that using a posterior approach may result in a longer length of harvestable tendon compared to an anterior approach. </p><p><br></p><p>HYPOTHESIS</p><p>The hypothesis was that there would be no difference in the length of the harvestable tendon between the anterior and posterior approaches.</p><p><br></p><p>STUDY DESIGN</p><p>Retrospective case-control study</p><p><br></p><p>METHODS</p><p>A retrospective study was conducted at the author’s institute using prospectively collected data from skeletally mature Chinese patients who underwent medial hamstring harvesting between January 2008 and December 2021. Patients were excluded if they had experienced graft harvesting complication or if only one medial hamstring was harvested. One-to-one exact matching was performed between the two approaches based on body height and sex. The outcomes assessed was the length of the harvested tendon.</p><p><br>RESULTS</p><p>A total of 536 patients underwent medial hamstring harvesting using an anterior approach, while 58 underwent it using a posterior approach, all of whom met the inclusion and exclusion criteria. Fifty-four matched pairs were identified. The length of the harvested semitendinosus tendon were 263 +/- 29 mm in the anterior approach and 256 +/- 28 mm in the posterior approach (p = 0.093, Student’s t-test). The average difference in the length of the harvested semitendinosus tendon between the two approaches was 7 mm. The length of the gracilis tendon was 226 +/- 29 mm and 223 +/- 29 mm in the anterior approach and the posterior approaches, respectively (p = 0.297, Student’s t-test). </p><p><br></p><p>CONCLUSION</p><p>In a retrospective one-to-one case-control study with exact matching of body height and sex, it was found that there was no difference in the length of the semitendinosus tendon and the gracilis tendon harvested using a posterior approach compared to an anterior approach. The average difference between the two approaches were 7 mm for the semitendinosus tendon and 3 mm for the gracilis tendon, respectively.</p>