The Rule of Twos: Technical Note on Consistent Anatomical Landmarks for Hamstring Graft Harvesting

We describe a novel hamstring harvesting technique using the “Rule of Twos” as an aide-memoire to dissect the conjoint tendon in an Asian population undergoing anterior cruciate ligament reconstruction.In a prospective study performed on 17 patients to validate this technique, a 2cm incision is placed 2cm distal and medial to the tip of the tibial tubercle. The surgeon then measured the following variables and calculated their means: 1) Distance from the tip of the tibial tuberosity to the proximal edge of the conjoint tendon (19.4±1.4mm), 2) Width of the conjoint tendon insertion (18.8±1.0mm), 3) Conjoint tendon length (20.1±1.0mm).
Source: Journal of Orthopaedics - Category: Orthopaedics Source Type: research