Operative treatment for the painful posterior thigh after hamstring autograft harvesting

Abstract

SummaryBackground: Semitendinosus (ST) is widely used autograft in anterior cruciate ligament reconstructions (ACLR). Although tendon harvesting is a common procedure, some patients exhibit pain, cramping and dysfunction in posterior thigh after the ACLR. The formation of the newly regenerated neotendon could be compromised by a new injury or too rapid rehabilitation. We present this clinical entity and the developed surgical technique and share our experience in treatment of these patients. Methods: Ten patients underwent operation where the harvested, retracted and loose muscle (9 ST, 1 gracilis) was reattached again. The delay to the diagnosis and the outcome of the procedure were recorded. Cases were followed and magnetic resonance images (MRI) were included from 2 cases for the demonstration of postoperative healing. Results: Six ST and the gracilis patients with prolonged symptoms had good results and returned to their normal activity level. Preoperative MRI showed increased signal intensity and edema of the harvested and retracted muscles as the sign of compromised healing of the neotendon. Postoperatively, these MRI findings were resolved.

A modified oblique incision in hamstring tendon graft harvesting during ACL reconstruction

“…Posterior thigh pain is another complication after hamstring autograft harvesting. Laakso et al [ 19 ] reported that ten athletes (7 males and 3 females) had experienced an injury to the harvested hamstring site after an ACL reconstruction and underwent operative treatment and obtained good result. They demonstrated that an early trauma during rehabilitation could commence more retraction to the harvested muscle itself and affect the regeneration of the neotendon.…”