APEX Foundations in Arthroscopy Basic Lectures-Harvest Technique

Video Transcription

Video Summary

This surgical demonstration covers three graft harvest techniques used in knee ligament reconstruction: hamstring tendon, patellar tendon, and quadriceps tendon harvests. <br /><br />For the hamstring harvest, the surgeon marks an incision near the tibial tubercle and metadiaphyseal flare, carefully dissecting to identify and free the gracilis and semitendinosus tendons from the pes anserine bursa and surrounding soft tissue. Special attention is given to avoid damaging the medial collateral ligament. The tendons are tagged and whip-stitched for control, then carefully stripped proximally using a closed tendon stripper, ensuring all fascial attachments are released to prevent tendon amputation during harvesting.<br /><br />The patellar tendon harvest involves a longitudinal incision from above the inferior patellar pole to the tibial tubercle. The central third of the tendon is outlined and harvested with attached bone blocks from the patella and tibia using measured saw cuts. The tendon and bone are carefully detached, and the donor site repaired in layers.<br /><br />Lastly, the quadriceps tendon harvest is done via a small incision above the patella. The surgeon isolates a 9-mm-wide tendon segment, detaching it from the superior pole of the patella. The tendon is whip-stitched and harvested using a specialized device aligned along fiber direction to avoid amputation. This soft-tissue graft allows secure fixation with retro drill sockets.<br /><br />Overall, the lecture emphasizes meticulous technique, proper anatomical identification, and controlled soft tissue dissection for optimal graft harvest and patient outcomes.

Keywords

knee ligament reconstruction

graft harvest techniques

hamstring tendon harvest

patellar tendon harvest

quadriceps tendon harvest

tendon dissection

soft tissue graft

surgical technique