Four-Strand Hamstring Braid Graft for Anterior Cruciate Ligament Reconstruction

Graft failure is a significant factor contributing to poor outcomes in anterior cruciate ligament reconstruction. A hamstring graft with a diameter of less than 8 mm is associated with nearly a 7-fold increase in the risk of failure. The technique proposed here introduces a hamstring braid graft configuration for anterior cruciate ligament reconstruction, offering a viable solution in cases where a larger graft diameter is needed. Mastering various hamstring graft preparation techniques is crucial to achieve an appropriate graft diameter and length that aligns with the patient's anatomy, height, and physical demands. In summary, the present technique, known as the Brazilian Braid, is a 4-strand hamstring braid graft that represents a reliable, easy-to-prepare, and reproducible graft preparation technique.