Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 23, Issue 7, pp 2115–2122 | Cite as

The hamstring muscle complex

  • A. D. van der Made
  • T. Wieldraaijer
  • G. M. Kerkhoffs
  • R. P. Kleipool
  • L. Engebretsen
  • C. N. van Dijk
  • P. Golanó
Sports Medicine

Abstract

Purpose

The anatomical appearance of the hamstring muscle complex was studied to provide hypotheses for the hamstring injury pattern and to provide reference values of origin dimensions, muscle length, tendon length, musculotendinous junction (MTJ) length as well as width and length of a tendinous inscription in the semitendinosus muscle known as the raphe.

Methods

Fifty-six hamstring muscle groups were dissected in prone position from 29 human cadaveric specimens with a median age of 71.5 (range 45–98).

Results

Data pertaining to origin dimensions, muscle length, tendon length, MTJ length and length as well as width of the raphe were collected. Besides these data, we also encountered interesting findings that might lead to a better understanding of the hamstring injury pattern. These include overlapping proximal and distal tendons of both the long head of the biceps femoris muscle and the semimembranosus muscle (SM), a twist in the proximal SM tendon and a tendinous inscription (raphe) in the semitendinosus muscle present in 96 % of specimens.

Conclusion

No obvious hypothesis can be provided purely based on either muscle length, tendon length or MTJ length. However, it is possible that overlapping proximal and distal tendons as well as muscle architecture leading to a resultant force not in line with the tendon predispose to muscle injury, whereas the presence of a raphe might plays a role in protecting the muscle against gross injury. Apart from these architectural characteristics that may contribute to a better understanding of the hamstring injury pattern, the provided reference values complement current knowledge on surgically relevant hamstring anatomy.

Level of evidence

IV.

Keywords

Hamstring muscles Biceps femoris Semitendinosus Semimembranosus Anatomy Injury mechanism 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • A. D. van der Made
    • 1
  • T. Wieldraaijer
    • 1
  • G. M. Kerkhoffs
    • 1
    • 6
  • R. P. Kleipool
    • 2
  • L. Engebretsen
    • 3
  • C. N. van Dijk
    • 1
  • P. Golanó
    • 4
    • 5
  1. 1.Department of Orthopaedic Surgery, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Department of Anatomy, Embryology and Physiology, Academic Medical CenterUniversity of AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Orthopaedic Surgery, University of Oslo Medical School and Oslo Sports Trauma Research CenterOslo University HospitalOsloNorway
  4. 4.Department of Pathology and Experimental Therapeutics, Human Anatomy UnitUniversity of BarcelonaBarcelonaSpain
  5. 5.Department of Orthopaedic SurgeryUniversity of Pittsburgh School of MedicinePittsburghUSA
  6. 6.Department of Orthopaedic SurgeryAcademic Medical CenterAmsterdamThe Netherlands

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