Abstract
Hamstrings identification and subsequent graft harvest can be made difficult by body habitus and variability in tendon anatomy. We describe a ‘sentinel’ blood vessel near the insertions of gracilis and semitendinosus to facilitate identification. A prospective study of 100 patients (100 knees) undergoing primary arthroscopic ACL reconstruction (via the anterior approach) with hamstrings graft was conducted. We searched for a ‘sentinel’ vessel and studied its position, orientation and perpendicular distance from the pes tendons. The ‘sentinel’ vessel was present in 98/100 knees. It passed from the superficial fascia to the periosteum at the pes insertion at a mean perpendicular distance of 8 mm from the upper border of the pes tendons. The ‘sentinel’ vessel was a consistent anatomical finding and served as a reliable guide in determining the pes insertion. Identifying this anatomical landmark allowed a small skin incision with limited wound dissection minimising risk of injury to the infra-patellar branch of the saphenous nerve.
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Babu, S., Gupte, C., Gajjar, S. et al. The ‘sentinel’ vessel: an anatomical landmark to identify the pes anserinus during hamstrings harvest for ACL reconstruction. Eur J Orthop Surg Traumatol 29, 1115–1118 (2019). https://doi.org/10.1007/s00590-019-02408-4
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DOI: https://doi.org/10.1007/s00590-019-02408-4