Chuaychoosakoon Chaiwat, Parinyakhup Wachiraphan, Boonriong Tanarat
Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanich Road, Hat Yai, Songkhla 90110, Thailand.
Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, 15 Karnjanavanich Road, Hat Yai, Songkhla 90110, Thailand.
Int J Surg Case Rep. 2021 Jun;83:105991. doi: 10.1016/j.ijscr.2021.105991. Epub 2021 May 15.
There are some possible complications during or after hamstring graft harvesting such as premature graft amputation, medial collateral ligament injury and infrapatellar branch of the saphenous nerve injury. Premature graft amputation can occur by inadequate removal of the accessory branches of the hamstring tendons, poor surgical technique and/or too sharp tendon stripper. In this study, we report a case of premature hamstring graft amputation due to degeneration caused by osteochondroma at the posteromedial aspect of the proximal tibia.
We reported the case of a 28-year-old Thai male who had an ACL injury was scheduled for ACL reconstruction. In this case, we had planned to use a hamstring graft for double-bundle ACL reconstruction. During the gracilis tendon harvesting, the graft was prematurely amputated by a tendon stripper at the level of the osteochondroma. The premature graft amputation was sent for pathology, which showed degenerated tissue.
In cases of osteochondroma at the posteromedial aspect of the proximal tibia, it is a chance of premature hamstring graft amputation. We suggest removing the osteochondroma before harvesting the tendon grafts to avoid the risk of premature graft transection.
在腘绳肌移植物获取过程中或之后可能会出现一些并发症，如移植物过早切断、内侧副韧带损伤和隐神经髌下支损伤。移植物过早切断可能是由于腘绳肌腱附属分支切除不充分、手术技术不佳和/或肌腱剥离器过于锋利所致。在本研究中，我们报告了一例因胫骨近端后内侧骨软骨瘤导致退变而引起的腘绳肌移植物过早切断的病例。
我们报告了一例28岁泰国男性，因前交叉韧带损伤计划进行前交叉韧带重建。在此病例中，我们计划使用腘绳肌移植物进行双束前交叉韧带重建。在股薄肌肌腱获取过程中，移植物在骨软骨瘤水平被肌腱剥离器过早切断。过早切断的移植物被送去做病理检查，结果显示为退变组织。
在胫骨近端后内侧出现骨软骨瘤的情况下，存在腘绳肌移植物过早切断的可能性。我们建议在获取肌腱移植物之前切除骨软骨瘤，以避免移植物过早切断的风险。
