ACL reconstruction using 5- or 6-strand hamstring autograft provides graft's diameter bigger than 8 mm

Knee Surg Sports Traumatol Arthrosc. 2018 May;26(5):1349-1356. doi: 10.1007/s00167-017-4668-6. Epub 2017 Aug 7.

Abstract

Purpose: The objective of this study was to measure the diameters of 5- and 6-strand hamstring autografts and to evaluate the predictability of their thickness by other body size indices.

Methods: Data were collected from 122 skeletally mature adult patients, who had undergone arthroscopic anterior cruciate ligament reconstruction using only 5- or 6-strand hamstring autografts. The diameters of tibial and femoral ends of the grafts were measured with the precision of 0.5 mm. Multiple linear regression was performed to determine the relationship between autograft's thickness and body size indices.

Results: The diameter of the femoral end of the 5-strand graft in male/female patients on average was 8.9/8.3 mm, while the femoral end of the 6-strand graft-9.3/8.5 mm (respectively). In 98.4% of the cases, 5- or 6-strand hamstring autografts were significantly thicker than 8 mm. In 5-strand group, a significant positive correlation was detected between the diameter of autograft's femoral end and patient's height (r = 0.55; p < 0.001), weight (r = 0.60; p < 0.001) and BMI (r = 0.43; p < 0.01). The 6-strand group had statistically significant correlations between the femoral end of the graft and height (r = 0.53; p < 0.001), and femoral end of the graft and weight (r = 0.50; p < 0.001).

Conclusions: Hamstring autografts were significantly thicker than 8 mm. Taller and heavier persons tended to have greater diameters of hamstring autografts; however, to better predict the diameter of autograft, body composition should be studied in relation to autograft's size. Preparation of 5- or 6-strand graft (using all the length of hamstring tendons) provides almost 100% of probability to obtain graft's diameter bigger than 8 mm.

Level of evidence: Level III.

Keywords: 5-strand; 6-strand; ACL reconstruction; Body size; Hamstring graft.

MeSH terms

  • Adult
  • Anterior Cruciate Ligament / diagnostic imaging
  • Anterior Cruciate Ligament / surgery*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Arthroscopy / methods*
  • Female
  • Femur / surgery
  • Hamstring Tendons / diagnostic imaging
  • Hamstring Tendons / transplantation*
  • Humans
  • Male
  • Retrospective Studies
  • Tendons / diagnostic imaging
  • Tendons / transplantation*
  • Tibia / surgery
  • Transplantation, Autologous