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Updated: Jun 16, 2026

Harvesting of Peroneus Longus Tendon Autograft
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Single versus double hamstring tendon harvest for ACL reconstruction.

Alberto Gobbi1

  • 1Orthopaedic Arthroscopic Surgery International, Bioresearch Foundation, via Amadeo 24, 20133 Milano, Italy. gobbi@cartilagedoctor.it

Sports Medicine and Arthroscopy Review
|February 18, 2010
PubMed
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This study presents a hamstring tendon harvesting technique for anterior cruciate ligament reconstruction. It preserves knee flexion and rotation strength by using only the semitendinosus tendon, avoiding gracilis sacrifice.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Biomechanical Engineering

Background:

  • Hamstring tendons are increasingly used for anterior cruciate ligament (ACL) reconstruction.
  • The choice between doubled semitendinosus versus quadrupled semitendinosus tendon grafts remains debated.
  • Sacrificing the gracilis tendon can lead to loss of knee flexion and internal rotation strength.

Purpose of the Study:

  • To introduce a novel surgical technique for hamstring tendon harvesting in ACL reconstruction.
  • To evaluate the feasibility of using only the semitendinosus tendon for single or double bundle ACL reconstruction.
  • To demonstrate how this technique preserves knee function compared to traditional methods.

Main Methods:

  • A specific technique for harvesting only the semitendinosus tendon is described.

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  • The technique is applicable to both single and double bundle ACL reconstruction procedures.
  • Comparison is made to methods involving gracilis tendon sacrifice.

    • Main Results:

    • The proposed technique allows for semitendinosus tendon harvesting without involving the gracilis.
    • This method aims to prevent the loss of deep knee flexion.
    • It also seeks to avoid the reduction in internal rotation strength associated with gracilis removal.

    Conclusions:

    • Harvesting only the semitendinosus tendon is a viable option for ACL reconstruction.
    • This technique offers a potential advantage by preserving key knee functions.
    • It provides an alternative approach that may improve patient outcomes and reduce functional deficits.