A new technique of graft harvest for anterior cruciate ligament reconstruction with quadruple semitendinosus tendon autograft.

A new technique of graft harvesting was used in 8 cases for arthroscopic anterior cruciate ligament reconstruction with quadruple semitendinosus tendon autograft. The graft is acquired through a small incision on the posteromedial aspect of the knee at the flexor crease instead of the standard anteromedial approach through a paramedian incision. Compared with the standard technique of graft harvesting, this new method of graft harvest facilitates easier identification of the semitendinosus and avoids inadvertent amputation of the semitendinosus tendon during graft harvest, disinsertion of the pes anserinus, or injury to the infrapatellar branch of saphenous nerve. The surgical scars, in addition to the standard portal scars, include a small scar on the posteromedial aspect, which merges into the flexor crease and a 1-cm anteromedial scar. This provides improved cosmesis and better patient compliance for early rehabilitation with less pain in the immediate postoperative period. There is no compromise on the intraoperative ligament reconstruction with good postoperative results. No intraoperative or postoperative complications were encountered. It would be advisable to follow this technique of graft harvesting for all individuals undergoing arthroscopic anterior cruciate ligament reconstruction using quadrupled semitendinosus tendon to avoid the problems encountered with the standard technique, and also to achieve an excellent cosmetic and functional outcome.