Evolution in ACL Autograft Harvesting Techniques: Transition to Minimally Invasive Autograft Harvesting

Evolution in ACL Autograft Harvesting Techniques: Transition to Minimally Invasive Autograft Harvesting

Published on the Journal of the American Academy of Orthopedic Surgeons

Surgical techniques for anterior cruciate ligament (ACL) reconstruction continue to evolve. Harvesting techniques for commonly used ACL autografts such as bone patellar tendon bone, hamstring, and quadriceps tendon have similarly continued to progress. Traditional larger incisions for graft harvesting that were described in the 1980s have given way to smaller or more minimally invasive techniques.

Advantages of these techniques are primarily anatomy based and include the following:

  • Decreased nerve complaints such as hypoesthesia or dysesthesia
  • Improved cosmesis
  • Decreased surgical site pain or morbidity
  • In the case of hamstring harvesting, easier tendon identification

The current literature supports reproducible minimally invasive or modified graft harvesting techniques for bone patellar tendon bone, hamstring, and quadriceps tendon autografts. Specialized instrumentation is available to simplify the harvesting process. Each of these techniques is described in detail outlining surgical steps, technical considerations, and precautions. Knowledge and review of these techniques providesthe surgeon with greater flexibility and options when choosing and harvesting autograft tissue for ACL reconstruction.

From the Andrews Institute for Orthopaedics and Genesee Orthopedics and Sports Medicine, New Hartford, NY. Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dennison and Andrews. Video content is available in the full text article online. Please visit https://dx.doi.org/10.5435/JAAOS-D-20-00693 Journal of the American Academy of Orthopaedic Surgeons: April 15, 2021 – Volume 29 – Issue 8 – p e380-e387 doi: 10.5435/JAAOS-D-20-00803

 

doctor

James M. Dennison, MD

Board-certified: Orthopedic Surgery, American Board of Orthopedic Surgeons; Subspecialty in Sports Medicine

Fellowship-trained: Sports Medicine, American Sports Medicine Institute (Dr. James Andrews and William Clancy)

Internship: General Surgery, Upstate Medical Center Residency: Orthopedic Surgery, Upstate Medical Center

MD: SUNY Health Science Center, Syracuse, NY

Member: American Academy of Orthopedic Surgery, American Sports Medicine Fellowship Society, American Society of Wilderness Medicine, American College of Sports Medicine

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Jessica Siuta

Jessica Siuta grew up in Utica, NY and graduated from Notre Dame High School. She received her undergraduate degree from Albany College of Pharmacy and Health Sciences. Jessica went on to complete her master’s degree from SUNY Upstate in Syracuse, NY. She completed elective rotations at Genesee Orthopedics during her PA program. She began working with Dr. Dennison in 2020 after graduation. Jessica lives with her husband and two dogs in Whitesboro, NY.

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