Complications Related to Hamstring Tendon Harvest

The semitendinosus, gracilis, and patellar tendons are the most commonly harvested grafts for anterior cruciate ligament reconstruction. The use of hamstring autografts offers the advantage of preserved quadriceps function, decreased anterior knee pain, and reduced risk of patellar tendon rupture and patellar fracture when compared with bone–patellar tendon–bone autografts. Harvesting of the semitendinosus and gracilis tendons is, however, not without complications including injuries to branches of the saphenous nerve, donor site pain, medial collateral ligament injury, premature graft amputation, and temporary hamstring weakness. We review the anatomy of the semitendinosus and gracilis tendons, describe potential morbidities of tendon harvesting, and discuss techniques that may minimize these complications.