From the Andrews Institute for Orthopaedics and Genesee Orthopedics and Sports Medicine, New Hartford, NY.
J Am Acad Orthop Surg. 2021 Apr 15;29(8):e380-e387. doi: 10.5435/JAAOS-D-20-00803.
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, and, 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 provides the surgeon with greater flexibility and options when choosing and harvesting autograft tissue for ACL reconstruction.
前交叉韧带（ACL）重建的手术技术不断发展。常用的 ACL 自体移植物（如髌腱骨、腘绳肌和股四头肌肌腱）的采集技术也同样不断发展。20 世纪 80 年代描述的传统较大切口采集移植物已经让位于更小或更微创的技术。这些技术的优点主要基于解剖学，包括以下几个方面：减少神经投诉，如感觉减退或感觉异常，改善美容效果，减少手术部位疼痛或发病率，以及在腘绳肌采集的情况下，更容易识别肌腱。目前的文献支持可重复的微创或改良的髌腱骨、腘绳肌和股四头肌肌腱自体移植物采集技术。专门的仪器可简化采集过程。这些技术中的每一种都有详细的描述，包括手术步骤、技术注意事项和预防措施。了解和审查这些技术为外科医生在选择和采集 ACL 重建用自体移植物组织时提供了更大的灵活性和选择。
