ArticleOrthopaedic journal of sports medicine2020
Failure Rates of 5-Strand and 6-Strand vs Quadrupled Hamstring Autograft ACL Reconstruction: A Comparative Study of 413 Patients With a Minimum 2-Year Follow-up.
Article in Orthopaedic journal of sports medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Anterior cruciate ligament reconstruction with six and eight-strand hamstring tendon autografts produces adequate graft dimensions and functional outcomes: A systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Pooled it
- Though five-strand hamstring autografts demonstrate greater graft diameter, postoperative outcomes are equivocal to four-strand hamstring autograft preparations: a systematic review and meta-analysis of level I and II studies.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Pooled it
- Quadriceps tendon autograft for pediatric anterior cruciate ligament reconstruction results in promising postoperative function and rates of return to sports: A systematic review.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Pooled it
- Type I Atelocollagen Interposition Within the ACL Graft During ACL Reconstruction: An Exploratory Clinical and MRI-Based Study.Medicina (Kaunas, Lithuania) · 2026Article
- The use of additional strands to increase graft diameter in primary ACL reconstruction provides optimal outcomes and does not compromise healing at 12-months follow-up.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Biomechanical Comparison of 4- and 6-Strand All-Inside Anterior Cruciate Ligament Reconstruction Grafts: The Value of Direct Tendon End Ripstop Suturing to the Adjustable Loop.Orthopaedic journal of sports medicine · 2026Article
- Anterior Cruciate Ligament Reconstruction: Common Intraoperative Mistakes and Techniques for Error Recovery.Current reviews in musculoskeletal medicine · 2025Review
- A meta-analysis of the hamstring tendon strands reconstruction in ACL: Functional outcomes based on strands number.Journal of experimental orthopaedics · 2025Article
- Propensity Score-Matched Comparison of Six-Strand All-Inside and Conventional Four-Strand Hamstring Autografts for ACL Reconstruction.Journal of clinical medicine · 2025Article
- Single bundle hamstrings autograft preparation techniques for anterior cruciate ligament reconstruction: current concepts.Archives of orthopaedic and trauma surgery · 2024Review
- The Influence of Different Hamstrings Assemblies on the Final Graft Diameter in Anterior Cruciate Ligament Reconstruction.Revista brasileira de ortopedia · 2024Article
- Comparison of the Clinical Outcomes between All-inside and Standard Technique in Anterior Cruciate Ligament Reconstruction with 6-strand Hamstring Tendon Autograft.Orthopaedic surgery · 2024Article
- Article
- Stand-Alone Tibial Interference Screw Fixation and Tibial Interference Screw Plus Tibial Staple Fixation Produce Comparable Outcomes After Primary Anterior Cruciate Ligament Reconstruction Using Hamstring Autografts.Arthroscopy, sports medicine, and rehabilitation · 2023Article
- Various Definitions of Failure Are Used in Studies of Patients Who Underwent Anterior Cruciate Ligament Reconstruction.Arthroscopy, sports medicine, and rehabilitation · 2023Review
- Meniscal resection increases the risk of residual knee laxity even in patients undergoing anatomic double-bundle anterior cruciate ligament reconstruction with eight strands of hamstring autografts.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2023Article
- Estimated diameter increase from a 4S to a 6S hamstring graft configuration - A cadaveric study.SICOT-J · 2023Article
- Quadruple Hamstring Autograft Technique for Anterior Cruciate Ligament Reconstruction Reduces Allograft Augmentation.Arthroscopy, sports medicine, and rehabilitation · 2022Article
- Trends in Primary Anatomical Single-Bundle Anterior Cruciate Ligament Reconstruction Practice in Adult Patients Prevalent Among Arthroscopy Surgeons of Six Southern States of India.Indian journal of orthopaedics · 2022Article
- Etiology of Failed Anterior Cruciate Ligament Reconstruction: a Scoping Review.Current reviews in musculoskeletal medicine · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnterior cruciate ligament reconstruction (ACLR) with hamstring autograft has gained popularity. However, an unpredictably small graft diameter has been a drawback of this technique. Smaller graft diameter has been associated with increased risk of revision, and increasing the number of strands has been reported as a successful technique to increase the graft diameter. PURPOSE: To compare failure rates of 5-strand (5HS) and 6-strand (6HS) hamstring autograft compared with conventional 4-strand (4HS) hamstring autograft. We describe the technique in detail, supplemented by photographs and illustrations, to provide a reproducible technique to avoid the variable and often insufficient 4HS graft diameter reported in the literature. STUDY
designCohort study; Level of evidence, 3.
methodsWe retrospectively reviewed prospectively collected data of all primary hamstring autograft ACLRs performed at our institution with a minimum 2-year follow-up and 8.0-mm graft diameter. A total of 413 consecutive knees met the study inclusion and exclusion criteria. The study population was divided into 5HS and 6HS groups as well as a 4HS control group. The primary outcome was failure of ACLR, defined as persistent or recurrent instability and/or revision ACLR.
resultsThe analysis included 224, 156, and 33 knees in the 5HS, 6HS, and 4HS groups, respectively. The overall ACLR failure rate in this study was 11 cases (8%): 5 cases for 5HS, 3 cases for 6HS, and 3 cases for 4HS. No statistically significant differences were found among groups (
conclusionThe 5HS and 6HS constructs have similar failure rates to the conventional 4HS construct of 8.0-mm diameter and are therefore safe and reliable to increase the diameter of relatively smaller hamstring autografts. We strongly recommend using this technique when the length of the tendons permits to avoid failures reportedly associated with inadequate graft size.
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