Hamstring Graft Preparation for ACL Reconstruction

Abstract

Anterior cruciate ligament (ACL) reconstruction represents one of the most common procedures in orthopedic surgery. It usually involves the harvest of both gracilis and semitendinosus tendons from the ipsilateral knee. Different methods of hamstring graft preparation have been proposed in recent years, to create an adequate graft diameter reducing morbidity linked to gracilis tendon harvesting procedure. More recently, the use of only 1 of the tendons (semitendinosus) in a tripled or quadrupled arrangement has been described, especially in an all-inside type of reconstruction. Having a thicker tendon with a quadrupled semitendinosus (ST), instead of double gracilis and ST enables to have a graft with enough diameter to resemble more closely the native ACL and decreases the risk of graft re-rupture. The present study aims to describe different options of hamstring graft preparing, listing and analyzing each configuration to help surgeons to choose the most suitable graft type for their patients.

Outcomes of RigidFix Cross Pin Fixation in Femoral and Tibial Tunnel for Anterior Cruciate Ligament Reconstruction

“…The diameter of the 4‐strand HT graft (2‐strand ST and 2‐strand GT) was only about 6.65 mm. We could not accept a tendon graft smaller than 7mm in diameter as it would significantly increase the failure rate 43–45 . So during the operation, when the 4‐strand graft diameter was less than 7 mm, we would further fold the HT to form a 5‐strand or 6‐strand graft to increase the graft diameter.…”

“…We could not accept a tendon graft smaller than 7mm in diameter as it would significantly increase the failure rate. [43][44][45] So during the operation, when the 4-strand graft diameter was less than 7 mm, we would further fold the HT to form a 5-strand or 6-strand graft to increase the graft diameter. As shown in the Table 4, the average diameter of each strand in group A was only 1.41 mm, which was less than 1.85 mm in group B.…”