Use of the 5-Strand Hamstring Autograft Technique in Increasing Graft Size in Anterior Cruciate Ligament Reconstruction.

Background: To determine the extent to which a strategy of routinely preparing a 5-strand hamstring autograft would increase graft size in anterior cruciate ligament (ACL) reconstruction.

Methods: A total of 64 patients were enrolled in a prospective randomized controlled study comparing 5-strand and quadrupled semitendinosus-gracilis autografts in single-bundle ACL reconstruction (5-strand group, n = 32; 4-strand group, n = 32). In the 5-strand group, the diameter of the 4-strand construct and the subsequent 5-strand graft used were measured, whereas in the 4-strand group, the diameter of the quadrupled graft used was measured.

A 5-Strand Hamstring Autograft Achieves Outcomes Comparable to Those of a 4-Strand Hamstring Autograft With a Graft Diameter of 8 mm or More in Anterior Cruciate Ligament Reconstruction.

Background: Quadrupled (4-strand) hamstring tendon autografts are commonly used in anterior cruciate ligament (ACL) reconstruction, but there is significant variability in their diameter. The 5-strand hamstring autograft has been used as a means of increasing the graft diameter in patients with undersized hamstring grafts.

Purpose: To report the outcomes of primary ACL reconstruction using 5-strand hamstring autografts in patients in whom the 4-strand configuration produced a graft diameter of <8 mm and to compare these outcomes with those of ACL reconstruction using 4-strand semitendinosus-gracilis autografts with a graft diameter of ≥8 mm.