title: Anatomy of the bands of the hamstring tendon: how can we improve harvest quality?
abstract: BACKGROUND
  The hamstring tendons, gracilis and semitendinosus are widely used in ligament and reconstructive surgery. Their accessory bands or insertions are technical pitfalls during harvesting.
  
  
  METHODS
  Thirty fresh cadaver knees have been studied, in order to 1) determine the anatomy of the bands of the gracilis and semitendinosus tendons, and, 2) to identify risk factors for failure during harvesting.
  
  
  RESULTS
  Semitendinosus always had at least one band, sometimes two, strong, tendinous, and generally running to the fascia of gastrocnemius medialis to which they are attached, at an acute angle in a distal direction. Their presence is constant and they are only exceptionally found more than 100 mm from the tendon's tibial insertion. Gracilis shows the greatest anatomical variability, and over one quarter have no bands (although there may be as many as three). Their location, destination and angle of attachment to the tendon vary greatly. These bands are mainly aponeurotic and less strong, but must be carefully and widely dissected.
  
  
  CONCLUSIONS
  Anatomical variability makes harvesting of pes anserinus tendons difficult. Three simple anatomical criteria have been highlighted that can be assessed by the surgeon during harvesting. The criteria are the insertion, the direction and the anatomical type of the bands.
authors: Institut Locomoteur, Service de Chirurgie Orthopédique et Traumatologique, Centre Hospitalier Universitaire Rangueil, Toulouse, France. nicolasreina@gmail.com
authors: Nicolas
authors: N
authors: Reina
authors: Olivier
authors: O
authors: Abbo
authors: Anne
authors: A
authors: Gomez-Brouchet
authors: Philippe
authors: P
authors: Chiron
authors: Jacques
authors: J
authors: Moscovici
authors: Jean-Michel
authors: JM
authors: Laffosse
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000033:anatomy & histology*; D008297:Male; D008875:Middle Aged; D013710:Tendons / Q000033:anatomy & histology*