Estimated diameter increase from a 4S to a 6S hamstring graft configuration - A cadaveric study

Area of Science:

• Orthopedic surgery
• Biomechanical engineering
• Sports medicine

Background:

• Graft diameter is crucial for anterior cruciate ligament (ACL) reconstruction outcomes.
• Optimizing graft diameter can reduce the risk of ACL graft failure.
• Hamstring autografts are commonly used in ACL reconstruction.

Purpose of the Study:

• To evaluate the impact of a 6-strand (6S) hamstring autograft configuration on graft diameter.
• To compare the graft diameter of the 6S configuration against the standard 4-strand (4S) configuration.

Main Methods:

• A cadaveric study involving 33 knees.
• Hamstring tendons (semitendinosus and gracilis) were harvested.
• Graft diameter was measured for both 4S and 6S configurations by three evaluators.

Main Results:

• The 6S configuration resulted in a median diameter increase of 1.5 mm compared to the 4S configuration (p < 0.001).
• 84% of 6S grafts achieved a diameter > 8 mm, versus less than one-third of 4S grafts.
• The 6S configuration offers a reliable method to achieve larger graft diameters.

Conclusions:

• The 6S hamstring graft configuration significantly increases graft diameter compared to the 4S configuration.
• This technique is valuable for achieving target graft diameters (e.g., 8.5 mm) in ACL reconstruction.
• The findings aid in pre-operative and intra-operative decision-making for optimizing graft selection and surgical outcomes.