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

ABSTRACT: 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.

SUBMITTER: Park HY

PROVIDER: S-EPMC8085571 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Hamstring Braid Graft Technique for Anterior Cruciate Ligament Reconstruction.

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Project description:Hamstring autografts are frequently used for anterior cruciate ligament reconstruction. The inherent variability in graft diameter has been stated as a disadvantage in its use because the presence of smaller graft diameters has been correlated with increased risk of re-rupture. Several techniques have been described to address this concern. Modifications of the basic Graftlink technique allows for increased control over final graft diameter using a standard harvest of the semitendinosus tendon with or without the gracilis tendon, and results in a graft of adequate length and diameter in all patients with rigid cortical fixation on the femur and tibia.

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Project description:Anterior cruciate ligament reconstruction is one of the most commonly performed procedures in orthopaedics, with more than 125,000 performed in the United States per year. There are several reconstruction graft choices that can be used to reconstruct the native anterior cruciate ligament, with autograft hamstring tendons being one of the most commonly used. Preparation of a hamstring autograft varies depending on patient characteristics and physician preference. The purpose of this Technical Note is to describe in detail different variants of hamstring graft preparation techniques that are commonly used in practice.

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Hamstring Graft Biological Preparation for Anterior Cruciate Ligament Reconstruction.

Project description:The all-inside anterior cruciate ligament reconstruction (ACLR) success depends on biologic integration of the graft in the bone tunnel. Sutures wrapping the tendon in the bone tunnel may affect tendon-bone healing in shorter bone tunnels. To achieve better graft integration, we propose a variation of the graft link suture technique wherein the graft is linked chain-like to the femoral and tibial TightRope (Arthrex), which increases the tendon-bone contact area by eliminating sutures from the noose of the graft and thus may allow better graft integration.

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Combined Reconstruction of the Anterior Cruciate Ligament and Anterolateral Ligament: Triple-Strand Braided Hamstring Graft for the Anterior Cruciate Ligament and Gracilis Strand for the Anterolateral Ligament With a Single Femoral Tunnel.

Project description:This article presents a surgical technique for combined reconstruction of the anterior cruciate ligament (ACL) and anterolateral ligament (ALL) of the knee using hamstring tendon graft. This approach involves creating a single femoral tunnel and using a triple-strand braided hamstring graft for the ACL and a strand of the gracilis tendon for the ALL. This technique aims to increase strength and improve knee stability, potentially reducing the risk of reinjury. The described method provides anatomic reconstruction of the ACL and ALL and allows for combined reconstruction with just 1 graft donor site. Another advantage is that the triple braided graft takes on a tape-like shape, mimicking the native form of the ACL and theoretically increasing biomechanical strength. Combined reconstruction of the ALL and ACL has shown excellent results in specific patient groups, reducing graft failure and improving outcomes in patients with a high risk of rupture. Thus, we describe a promising option for ligament reconstruction in cases of combined ACL and ALL injuries. This method may be a valuable alternative for orthopaedic surgeons, combining anatomic reconstruction with the use of a single donor site.

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