Four-Strand Hamstring Diamond Braid Technique for Anterior Cruciate Ligament Reconstruction

Hee-Yon Park1, Brandon Gardner1, Joo Yeon Kim1

  • 1Advanced Orthopaedics and Sports Medicine, San Francisco, California, U.S.A.

Several factors affect the success of an anterior cruciate ligament reconstruction, including graft origin, type, and morphology. Hamstring and bone-patellar tendon-bone autografts are the most widely used, and there are many different techniques of graft preparation with each. In this Technical Note and accompanying video, a 4-strand hamstring autograft technique is described that uses a simple diamond-type braid to produce a more ovoid morphology with increased cross-sectional area. Increased graft diameters have been associated with higher success rates and more positive long-term outcomes. Therefore, this braiding construct may provide additional tensile strength with increased resistance to failure than grafts that are otherwise undersized using conventional techniques.

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