The 8-Strand Hamstring Autograft in Anterior Cruciate Ligament Reconstruction

Growing participation in youth athletics has resulted in increased numbers of anterior cruciate ligament (ACL) injuries in skeletally immature patients. Use of autogenous graft material has been associated with improved graft survival. However, pediatric patients sometimes possess hamstring tendons that produce smaller-diameter grafts than those prepared with adult autogenous materials. Smaller-diameter grafts may predispose younger patients to graft failure. We describe a technique that increases the diameter of the ACL construct through the use of an 8-strand autologous hamstring tendon graft. The 8-strand ACL autograft is commonly used in all-inside ACL reconstruction surgery.