Comparison of Medial Hamstring Length Between Harvesting Methods Using Anterior and Posterior Approaches

Medial hamstring tendons harvesting can be performed through either an anterior or a posterior approach. It has been suggested that using a posterior approach may result in a longer length of harvestable tendon compared with an anterior approach.

There would be no difference in the length of the harvestable tendon between the anterior and posterior approaches.

Case-control study; Level of evidence, 3.

A retrospective study was conducted at the primary institution using prospectively collected data from skeletally mature Chinese patients who underwent medial hamstring tendons harvesting between January 2008 and December 2021. Patients were excluded if they had experienced graft harvesting complication or if only 1 medial hamstring tendon was harvested. One-to-one exact matching was performed between the 2 approaches based on body height and sex. The outcome assessed was the length of the harvested tendon.

A total of 536 patients underwent medial hamstring tendons harvesting using an anterior approach, while 58 underwent it using a posterior approach, all of whom met the inclusion criteria. A group of 54 matched pairs were identified. The length of the harvested semitendinosus tendon was 263 ± 29 mm in the anterior approach and 256 ± 28 mm in the posterior approach (P = .09; Student t test). The mean difference in the length of the harvested semitendinosus tendon between the 2 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 approach, respectively (P = .30; Student t test).

In a retrospective 1:1 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 with an anterior approach. The mean difference between the 2 approaches was 7 mm for the semitendinosus tendon and 3 mm for the gracilis tendon, respectively.