ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2021
Five- and six-strand hamstring grafts consistently produce appropriate graft diameters for anterior cruciate ligament reconstruction.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline 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
- The Rectus Femoris Tendon Graft for ACL Reconstruction: Predictive Anthropometry and Surgical Pearls Based on a Prospective Case Series.Orthopaedic journal of sports medicine · 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
- Peroneus Longus Versus Hamstring Tendon Graft for Anterior Cruciate Ligament Reconstruction: A Retrospective Matched Comparison.Journal of clinical medicine · 2025Article
- Four-Strand Hamstring Autografts Less Than 8-mm Wide Provide Less Capability for Conversion to a 6- or 7-Strand Graft Than Larger-Diameter Hamstring Autografts.Arthroscopy, sports medicine, and rehabilitation · 2025Article
- Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Shows Reduced Graft Failure Rates and Superior Residual Rotational Stability Regardless of Anterolateral Ligament Reconstruction Graft: A Systematic Review.Journal of clinical medicine · 2025Review
- Remnant Preservation Anterior Cruciate Ligament Reconstruction: Modified All-Inside Technique With Appendiceal Tibial Tunnel.Arthroscopy techniques · 2025Article
- The new auto graft technique in anterior cruciate ligament reconstruction.Northern clinics of Istanbul · 2025Article
- Minimizing Unnecessary Harvesting of an Extremely Thin Gracilis Tendon During ACL Reconstruction by Referencing the Diameter of the Doubled Semitendinosus Tendon Alone.Orthopaedic journal of sports medicine · 2025Article
- Single bundle hamstrings autograft preparation techniques for anterior cruciate ligament reconstruction: current concepts.Archives of orthopaedic and trauma surgery · 2024Review
- Estimated diameter increase from a 4S to a 6S hamstring graft configuration - A cadaveric study.SICOT-J · 2023Article
- Remnant preserving ACL reconstruction with a functional remnant is related to improved laxity but not to improved clinical outcomes in comparison to a nonfunctional remnant.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2022Article
- Quadriceps Tendon Autograft in Pediatric ACL Reconstruction: Graft Dimensions and Prediction of Size on Preoperative MRI.Orthopaedic journal of sports medicine · 2021Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeHamstring tendon graft diameter less than 8 mm has been correlated with an increased risk of anterior cruciate ligament reconstruction (ACLR) graft failure. The purpose of this study was to measure and compare the diameter of 3-, 4-, 5-, and 6-strand gracilis and semitendinosus (ST) hamstring tendon (HT) ACLR grafts, and to determine if there is a correlation between anthropometric data, HT length, and diameter of the HT ACLR graft.
methodsMale patients (n = 78) undergoing primary or revision ACLR with a HT autograft between July 2018 and March 2020 were recruited. Pre-operative anthropometric data was collected. Gracilis and ST tendons were harvested and the length and diameter measured. The following HT graft configurations were prepared in each patient: triple ST; double gracilis + double ST; double gracilis + triple ST; triple gracilis + triple ST. Paired t-tests and Pearson's correlation coefficients were used to assess demographics, anthropometrics, graft diameter, and tendon length. A non-parametric test was used to compare femoral and tibial ACL graft diameters of the 3-, 4-, 5-, and 6-strand HT graft configurations.
resultsFor the femoral end, 10%, 19%, 69% and 86% of the patients achieved graft diameters of equal to or greater than 8 mm in 3-, 4-, 5- and 6-strand HT graft configurations respectively. For the tibial end, 27%, 10%, 83%, and 92% of the patients achieved graft diameters of equal to or greater than 8 mm in 3-, 4-, 5-, and 6-strand HT graft configurations respectively. The largest increases in HT graft diameters were noted between the femoral end of 6- vs. 3-strand grafts (mean difference 1.7 ± 0.5 mm; p < 0.001) and between the tibial end of 6- vs. 4-strand grafts (mean difference 2.0 ± 0.5 mm; p < 0.001). Height and leg length were moderately positively correlated with ST tendon length (r = 0.54-0.51) and gracilis tendon length (r = 0.52-0.45), and thigh and shank lengths were moderately positively correlated with ST tendon length (r = 0.43 and 0.40, respectively).
conclusionTraditional 4-strand HT ACL autografts in male patients undergoing ACLR in the United Arab Emirates result in graft diameters less than 8 mm in the majority of patients. LEVEL OF EVIDENCE: III.
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