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Premature hamstring graft amputation during harvesting in ACL reconstruction
Chaiwat Chuaychoosakoon1, Wachiraphan Parinyakhup1, Tanarat Boonriong1
1Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanich Road, Hat Yai, Songkhla 90110, Thailand.
International Journal of Surgery Case Reports
|May 21, 2021
Summary
Osteochondroma on the proximal tibia can cause premature hamstring graft amputation during anterior cruciate ligament reconstruction. Removing the osteochondroma before tendon harvesting is recommended to prevent graft transection.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomedical Engineering
Background:
- Hamstring graft harvesting for ACL reconstruction carries risks, including premature graft amputation.
- Causes of amputation include inadequate accessory branch removal, poor technique, or sharp instruments.
- Osteochondroma is identified as a potential cause of graft degeneration and amputation.
Purpose of the Study:
- To report a case of premature hamstring graft amputation.
- To highlight the role of osteochondroma in graft complications.
- To provide recommendations for preventing graft transection.
Main Methods:
- Case report of a 28-year-old male undergoing ACL reconstruction.
- Planned use of a hamstring graft for double-bundle reconstruction.
- Observation of premature amputation of the gracilis tendon during harvesting due to osteochondroma.
Main Results:
- The hamstring graft was prematurely amputated by a tendon stripper at the site of the osteochondroma.
- Pathological examination of the amputated graft revealed degenerated tissue.
- This indicates osteochondroma can compromise graft integrity.
Conclusions:
- Osteochondroma at the posteromedial proximal tibia poses a risk for premature hamstring graft amputation.
- Pre-harvesting removal of osteochondromas is advised to mitigate the risk of graft transection.
- This finding is crucial for orthopedic surgeons performing ACL reconstructions.
