Hamstring tendons insertion – an anatomical study

Abstract

Objective To study the anatomy of the hamstring tendons insertion and anatomical relationships. Methods Ten cadaver knees with medial and anterior intact structures were selected. The dissection was performed from anteromedial access to exposure of the insertion of the flexor tendons (FT), tibial plateau (TP) and tibial tuberosity (TT). A needle of 40 × 12 and a caliper were used to measure the distance of the tibial plateau of the knee flexor tendons insertion at 15 mm from the medial border of the patellar tendon and tibial tuberosity to the insertion of the flexor tendons of the knee. The angle between tibial plateau and the insertion of the flexor tendons of the knee (A-TP-FT) was calculated using Image Pro Plus software. Results The mean distance TP-FT was 41 ± 4.6 mm. The distance between the TT-FT was 6.88 ± 1 mm. The (A-TP-FT) was 20.3 ± 4.9°. Conclusion In the anterior tibial flexor tendons are about 40 mm from the plateau with an average of 20°.

Eccentric and Concentric Motion Motion of Hamstring during the Leg Curl

“…The region clearly depicts that the insertion cannot lie very close to the pivot. However, the practically valid insertion is around 3 to 4 cm and that can only vary for different persons on a smaller scale such as one tenth or one hundredth of a centimeter (Grassi et al, 2013). With the increase in weight of lower leg from 5 to 15 kg at constant distance from the pivot to insertion 3 cm, the magnitude of force gets increased from about 3.60 to 4.79 kN [Fig.…”

“…For simplicity, we would not take kinetic as well as static frictions present in the knee joint. In a study of ten cadaver knees, it was found that the mean distance between tibial plateau and the flexor tendons is 41.0±4.6 mm (Grassi et al, 2013). This distance is loosely equal to the insertion of hamstring around tendon.…”

Inferior Medial Geniculate Artery Branch as an Anatomical Landmark for Hamstring Harvest During Anterior Cruciate Ligament Reconstruction

“…Inaccurate isolation of hamstring tendons can damage structures adjacent to the pes anserinus insertion, such as the infrapatellar branch of the saphenous nerve, or cause greater soft-tissue injury due to inappropriate incision location. 1 , 2 Flexor tendons can be compromised, and tendons may subsequently need to be harvested from a second donor site. Indeed, the semitendinosus and gracilis tendon are covered by a fibrotic cap formed by the tendon of the sartorius fascia that may make access to the hamstrings more challenging.…”

“…Indeed, the semitendinosus and gracilis tendon are covered by a fibrotic cap formed by the tendon of the sartorius fascia that may make access to the hamstrings more challenging. 2 …”

“…Indeed, the semitendinosus and gracilis tendon are covered by a fibrotic cap formed by the tendon of the sartorius fascia that may make access to the hamstrings more challenging. 2 Importantly, the size and quality of the graft have been shown to affect the outcome 3,4 where a minimum graft diameter of 8 mm is recommended to replicate the native ACL diameter. 3 Hence, accurate isolation of the hamstring tendons at the pes anserinus is crucial to successful graft harvesting.…”