Glossary
Hamstring graft
Quick answer
A hamstring graft uses one or two of the thin tendons at the back of the thigh, usually the semitendinosus and sometimes the gracilis, folded into a strong cord to replace a torn ACL. Knee surgeon Dr. Pablo Gelber uses it regularly at Aman Hospital in Doha, Qatar.
What it is
The tendons are taken through a short cut on the inner side of the upper shin, just below the knee. They are cleaned, folded into three, four or more strands and sized so the graft is thick enough. It is then passed through tunnels drilled in the shinbone and thighbone and fixed at each end.
The same tendons are also used to rebuild other ligaments, such as the MPFL for kneecap instability.
Why it matters for patients
Hamstring grafts leave a small scar and, in many patients, less pain at the front of the knee when kneeling compared with a patellar tendon graft. This can matter for prayer and floor sitting.
The thigh may feel tight or bruised for a few weeks, and early hamstring strength is lower. Sudden sprinting or heavy hamstring loading is introduced gradually, and a cramp-like pull at the back of the thigh in the first weeks needs care rather than alarm.
Who it suits
It is a common choice for many recreational and competitive athletes. It may be less suitable for some sprinters, people with very small tendons or knees with marked looseness, where another graft or an added lateral tenodesis may be advised after examination.
Frequently asked questions
Will my hamstring grow back?
The semitendinosus often regenerates partly into a tendon-like structure over months, and the surrounding muscles take over its work, so most people recover functional strength.
Why does the inside of my shin feel numb after surgery?
A small skin nerve runs near the harvest site. Numbness over a patch of skin is common, usually harmless, and often shrinks over the following months.
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