Abstract

PurposeThe purpose of this study was to determine the effect of the weave technique for hamstring graft preparation on the diameter of the prepared graft, functional outcome, and need for harvesting of semitendinosus and gracilis (ST + G) or semitendinosus alone (ST).Materials and MethodsThis retrospective study evaluated 340 patients who underwent arthroscopic anterior cruciate ligament (ACL) reconstruction from January 2013 to December 2015. Our protocol for graft preparation is that the graft length must be a minimum of 8 cm and the diameter must be between 7 and 10 mm. The parallel-graft preparation technique was used in 189 patient and the weave technique was used in 151 patients. Outcome was measured by using stress radiographs and International Knee Documentation Committee (IKDC) 2000 score.ResultsIn the parallel-graft preparation group, ST + G was used in 99 patients and ST was used in 90 patients. In the weave-graft preparation group, ST + G was used in 38 patients and ST alone was sufficient in 113 patients. The need for G harvest was less in the weave-technique group (p < 0.0001). There was no statistically significant difference at 2 years of follow-up in stress laxiometry, IKDC 2000 scores and rerupture rates between the two groups.ConclusionThe weave technique helps to reduce the need for G harvest without compromising functional outcome.Level of evidence IV.

Highlights

  • Reconstruction of the anterior cruciate ligament (ACL) is recommended for the prevention of instability, further intra-articular disease, and recurrent injury in the ACLdeficient knee [1]

  • The weave technique helps to reduce the need for G harvest without compromising functional outcome

  • At 2-year follow-up, there was no difference between the two groups in terms of functional outcome that was measured using International Knee Documentation Committee (IKDC) 2000

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Summary

Introduction

Reconstruction of the anterior cruciate ligament (ACL) is recommended for the prevention of instability, further intra-articular disease, and recurrent injury in the ACLdeficient knee [1]. Evaluation of patient muscle strength after ACL reconstruction is used to determine whether the patient can safely return to their pre-injury activity level [3]. Most of the studies that have evaluated autologous ST and STGR grafts have focused on postoperative graft remodeling and knee-flexor strength [4]. Studies examining the Biomechanical studies using animal tendons to determine the effect of braiding or twisting on initial graft strength and stiffness have not yielded clear conclusions. A study done by Kim et al on human tendons show that twisting and braiding reduces the tensile strength and stiffness of human hamstring tendon grafts used for

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