An In-Vivo Study of the Accesory Bands of Hamstring Tendons

Abstract

Background. The objective of our study is to determine the characteristics of accessory bands of hamstring tendons and their implications for a successful graft harvest during Arthroscopic ACL reconstruction

Method. 30 middle-aged patients,17 males and 13 females with Anterior cruciate ligament injuries posted for arthroscopic ligament reconstruction were included in this study. Both semitendinosus and gracilis graft were harvested in all patients. The number of bands in each tendon and their location from the tendon insertion is measured and recorded

Results. The majority of patients in the study had two accessory bands of semitendinosus (66.67%). Other enrolled patients either had one accessory band (20%) or three accessory bands (13.33%). On the other hand, the majority patients (76.67%) had no accessory bands of gracilis, while the remaining had one accessory band. Of all the gracilis tendons, a single accessory band was observed in 7 tendons. They were found arising at a distance ranging from 4-6 cm from the tendon insertion at the tibial crest. For the semitendinosus, there was always a constant distal band arising at distance ranging from 3-7 cm. 13% of semitendinosus had a 3 accessory band with the most proximal band arising at 9-11 cm. 66.67% had only 2 accessory bands with the proximal band found at a distance of 8-10 cm measured from the insertion point

Conclusion Although accessory bands are highly variable in their location, we have observed that none of the bands were located more than 11 cm from the tendon insertion point. Tendon stripper can be safely advanced beyond this point