Grafting Technique Research Articles

Comparative evaluation of multi-fold rib and structural iliac bone grafts in single-segment thoracic and thoracolumbar spinal tuberculosis: clinical and radiological outcomes

ObjectiveTo compare clinical and radiological outcomes of multi-fold rib and structural iliac bone grafts, the primary autologous graft techniques in anterolateral-only surgery for single-segment thoracic and thoracolumbar spinal tuberculosis.MethodsThis retrospective study included 99 patients treated from January 2014 to March 2022, categorized into 64 with multi-fold rib grafts (group A) and 35 with structural iliac bone grafts (group B). Outcomes assessed included hospital stay, operation time, intraoperative blood loss, postoperative drainage, complications, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), the Visual Analog Scale (VAS) for pain, the Oswestry Disability Index (ODI), bone fusion time, and the American Spinal Injury Association (ASIA) impairment scale grade. Segmental kyphotic angle and intervertebral height were measured radiologically before surgery and follow-up.ResultsThe mean follow-up was 63.50 ± 26.05 months for group A and 64.97 ± 26.43 months for group B (P > 0.05). All patients had achieved a clinical cure. Group A had a shorter operation time (P = 0.004). Within one week post-surgery, group B reported higher VAS scores (P < 0.0001). Neurological performance and quality of life significantly improved in both groups. No significant differences were observed in segmental kyphotic angle and intervertebral height between the groups pre- and postoperatively (P > 0.05). However, group A showed a greater segmental kyphotic angle at the final follow-up, while group B had better maintenance of kyphotic angle correction and intervertebral height (P < 0.05). Bone fusion was achieved in all patients without differences in fusion time (P > 0.05).ConclusionsMulti-fold rib grafts resulted in shorter operation times and less postoperative pain, while structural iliac bone grafts provided better long-term maintenance of spinal alignment and stability, suggesting their use in cases where long-term outcomes are critical.

Open Coronary Endarterectomy to LAD in CABG Surgery: The Impact of Surgical Grafting Technique of LIMA-To-LAD on Early Clinical Outcome and Mid-Term Angiographic Patency

Open Coronary Endarterectomy to LAD in CABG Surgery: The Impact of Surgical Grafting Technique of LIMA-To-LAD on Early Clinical Outcome and Mid-Term Angiographic Patency

Split-thickness Plantar Skin Graft for Foot Syndactyly.

For the treatment of syndactyly, the submalleolar or inguinal area is the common donor site for skin grafts. However, high skin tension of the submalleolar area could potentially delay wound healing or cause scarring. Skin grafts from the inguinal area cause pigmentation. In this study, we have harvested split-thickness skin grafts from the plantar area to treat syndactyly and evaluated the healing course and aesthetic outcome. We analyzed 13 recipient and nine donor sites in eight patients, aged 13-68 months (average 25 months), with syndactyly of the foot. The minimum follow-up was 14 months, and average follow-up period was 22.3 months. Aesthetic outcomes including color and texture match, wound healing of donor site using Vancouver Scar Scale, and complications of both sites were assessed in all patients. At the recipient sites, the graft survived well, and the lack of pigmentation of the graft led to good color match. At the donor sites, hypertrophic scar and high scar scale were seen around postoperative month 3, but were momentary, as all donor sites matured to a flat and soft scar. Morbidity of split-thickness skin graft from the plantar region is limited. It causes minimum scarring of the nonexposed area. Moreover, because it does not cause pigmentation, the split-thickness skin graft technique is a reasonable option for the treatment of syndactyly.

Fabrication and characterizations of simvastatin-containing mesoporous bioactive glass and molybdenum disulfide scaffold for bone tissue engineering.

Due to the limitations of the current treatment approaches of allograft and autograft techniques, treating bone disorders is a significant challenge. To address these shortcomings, a novel biomaterial composite is required. This study presents the preparation and fabrication of a novel biomaterial composite scaffold that combines poly (D, L-lactide-co-glycolide) (PLGA), mesoporous bioactive glass (MBG), molybdenum disulfide (MoS2), and simvastatin (Sim) to address the limitations of current bone grafting techniques of autograft and allograft. The fabricated scaffold of PLGA-MBG-MoS2-Sim composites was developed using a low-cost hydraulic press and salt leaching method, and scanning electron microscopy (SEM) analysis confirmed the scaffolds have a pore size between 143 and 240 μm. The protein adsorption for fabricated scaffolds was increased at 24 h. The water adsorption and retention studies showed significant results on the PLGA-MBG-MoS2-Sim composite scaffold. The biodegradation studies of the PLGA-MBG-MoS2-Sim composite scaffold have shown 54% after 28 days. In vitro, bioactivity evaluation utilizing simulated body fluid studies confirmed the development of bone mineral hydroxyapatite on the scaffolds, which was characterized using x-ray diffraction, Fourier transform infrared, and SEM analysis. Furthermore, the PLGA-MBG-MoS2-Sim composite scaffold is biocompatible with C3H10T1/2 cells and expresses more alkaline phosphatase and mineralization activity. Additionally, in vivo research showed that PLGA-MBG-MoS2-Sim stimulates a higher rate of bone regeneration. These findings highlight the fabricated PLGA-MBG-MoS2-Sim composite scaffold presents a promising solution for the limitations of current bone grafting techniques.

Comparison of Keratometric Change Following Various Conjunctival Autografting Techniques in Pterygium Surgery.

Aim To compare the postoperative keratometric changes and duration of surgery for different techniques of conjunctival autografting in pterygium surgery. Methods Patients with primary pterygium attending the outpatient department and having appropriate indications for surgery were enrolled. Preoperative ophthalmic examination included visual acuity assessment, refraction, keratometry, slit lamp, and fundus evaluation. Pterygium excision surgery with conjunctival autografting was performed on all patients using one of the four different techniques, namely, sutures, fibrin glue, and the autologous bloodand bridge techniques. Duration of surgery was recorded for all patients. Postoperatively, all patients were followed up on Day 1, Day 7, and Months 1, 3, and 6. Duration of surgery, keratometric changes, and recurrence rates were analyzed in all four groups. Results Sixty-eight eyes of 66 patients completed the study protocol. There was a significant reduction in astigmatism after the autologous blood graft technique (P value 0.0055) and the glue technique (P value < 0.0001). The success rate of the autologous and glue technique was 90%. The glue technique was found to be more time efficient (mean duration 20.40 minutes) than other techniques. Conclusion After pterygium excision, conjunctival auto grafting using either autologous blood or glue plays a significant role in reducing pterygium-induced astigmatism and recurrence rates with the added advantage of a shorter operative time.

Sosialisasi Alternatif Perbanyakan Tanaman Kakao pada Fase Pembibitan Menggunakan Metode Sambung Pucuk

Superior seeds will guarantee good growth and high production levels if treatment is carried out optimally. To support plant development so that it is successful, the first step is to prepare planting material in the nursery. Efforts that can be made to support and increase cocoa production are through rejuvenating cocoa using the shoot grafting technique. Shoot grafting is often used by combining rootstock and scion. The rootstock is expected to be a stem that is resistant to soil pathogens and sturdy, while the scion is the part that has the desired production characteristics. Tools and materials used: grafting knife, plastic lid, raffia rope, sharpening stone, scion (scion). This activity was carried out in August-December 2023 in Bloro Village, Nita District, Sikka Regency using socialization and demonstration methods, interviews and literature reviews. prepare the rootstock from the seed nursery, the rootstock must have the following criteria: the plant grows healthily and is not attacked by pests and diseases, has strong roots, and the seed comes from a superior variety. The scion/tribe of the mother tree with the MCC 02 variety is productive, healthy and resistant to pest and disease attacks. Grafting is carried out on 3-month-old seedlings, by leaving 4-5 leaves, then the lower stem is split about 2 cm using a grafting knife so that both sides are the same. The entry is cut into a sharp or wedge shape and then inserted into the split rootstock. The entry that has been inserted is then tied with string, covered with ice plastic and tied again, when the shoots start to appear, the plastic is ready to be opened.

The Use of Autologous Tibia Strut Grafts to Enhance Bone Healing of an Infected Long-Bone Nonunion

We treated five patients with an infected non-union of the femur and tibia with autologous tibia strut grafts. All patients had bone defects ranging from three to nine centimeters. Three patients suffered for more than seven years from chronic osteitis. Our objective was to describe this grafting technique and its results. We focused on healing time, postoperative complications and functional recovery. We retrospectively studied five patients with an infected non-union of the lower limb who had undergone previous surgeries to overcome the bone healing problem. In this group of patients, we had four femur non-union and one tibia non-union. All of them had a previous infection episode, in which medical and surgical therapy was needed. Of the participants, three were men, and two were females with a mean age of 43.3 years (28-55).

MiR-379-3p inhibits fat grafting survival and angiogenesis by targeting SOCS1-mediated adipose inflammation

BackgroundThis research probed the relevant mechanism of miR-379-3p by regulating suppressor of cytokine signaling1 (SOCS1) in the processes of inflammation, oxidative stress, and angiogenesis in fat grafting. An increasing body of research indicates the involvement of miRNA/mRNA pathways in the process of fat transplantation, yet the underlying molecular mechanisms remain to be fully elucidated. ResultsmiR-379-3p knockdown improved the survival rate of adipocytes, promoted adipose tissue angiogenesis, and reduced inflammation and oxidative stress levels. miR-379-3p targeted SOCS1. SOCS1 upregulation improved adipose tissue survival and angiogenesis and reduced inflammation. miR-379-3p affected adipose tissue survival, angiogenesis, and inflammation by targeting SOCS1 expression. ConclusionsmiR-379-3p inhibits fat grafting survival and angiogenesis by targeting SOCS1 to mediate adipose inflammation, suffering a novel way to improve fat grafting technique development.How to cite: Zhu J, Zhao F, Han X, et al. miR-379-3p inhibits fat grafting survival and angiogenesis by targeting SOCS1-mediated adipose inflammation. Electron J Biotechnol 2024:67. https://doi.org/10.1016/j.ejbt.2023.11.001.

Arthroscopic Bone Grafting and Robot-assisted Fixation for Scaphoid Nonunion.

Scaphoid nonunion remains a challenging problem to manage with no general consensus on its treatment recommendations. We propose a novel minimally invasive (MIS) technique of arthroscopic bone grafting (ABG) with robot-assisted fixation for the treatment of scaphoid nonunions. Patients with radiographically proven scaphoid nonunion treated by this novel surgical technique were included. Following arthroscopic debridement and iliac crest bone grafting, the scaphoid was fixed percutaneously using either multiple Kirschner (K)-wires or a headless compression screw using a robotic navigation system. Six male patients with an average age of 29.2 years were enrolled. Four patients had scaphoid waist fractures, and the other two were proximal pole fractures. During wrist arthroscopy, punctate bleeding of the proximal scaphoid fragment was observed in four out of the six patients. Half of the patients were fixed using a headless compression screw and the other half using multiple K-wires. All the guidewires were placed with a single-attempt using the robotic navigation system. Postoperatively, all the scaphoid fractures had complete radiographic union by 16 weeks. At a mean follow-up of 18.3 months, there were significant improvements in wrist range of motion, grip strength, and patient-rated outcomes. No intraoperative or early postoperative complications were encountered in any of our patients. Arthroscopic bone grafting with robot-assisted fixation is a feasible and promising therapeutic option for scaphoid nonunions, regardless of the vascularity of the proximal pole fragment. This novel technique allows for anatomic restoration of the scaphoid alignment and accurate, targeted placement of implants into the scaphoid nonunion site within a single-attempt using a robotic navigation system.

Enhancing the Wettability of Fibre Surface: A Comparative Experimental Study of Different Surface Activation Principles on Single Polyamide Fibre

In this study, we have compared three different principles of surface activation with regard to their effects on the properties of single polyamide fibres. The techniques used include the complexation-mediated surface treatment using CaCl2/EtOH/H2O solution (CEW), the atmospheric pressure plasma treatment with air (APPA) and grafting polymerisation process with 2- hydroxyethyl methacrylate (HEMA). The CEW modification, the plasma treatment and the grafting process induced a decrease in advancing contact angle and thus led to an improved wettability of the polyamide fibre. While for the CEW treatment, the decrease was solely due to a change in topography such as increased surface roughness leading to increased capillary effect, for the APPA and grafting technique the decrease was attributed to a combination of increased surface roughness and increased amount of oxygen or nitrogen-containing groups as detected by XPS. In addition, the fibre fineness decreased in the case of CEW treatment due to a dissolution of polyamide segments during the modification, while it increased in the grafting process due to an additional grafted layer. However, an increase in wetted length was observed for most samples, which was attributed to the increased waviness of the fibres. All treatments induced a decrease in fibre tensile strength that decreased with increasing treatment intensity.

Surgical results of retroauricular fascia graft in frontalis suspension surgery: A case series study

Frontalis suspension surgery is commonly used for repair of congenital ptosis and involutional blepharoptosis with poor levator function. Grafts for this procedure have been developed using many a variety of different materials, each with advantages and disadvantages. The retroauricular fascia graft might be beneficial in this surgery. This article reports the surgical results of blepharoptosis, who were treated with the retroauricular fascia, which is a new autologous graft for the frontalis suspension technique. This case series study targeted patients with ptosis who underwent frontalis suspension surgery with the retroauricular fascia graft at Wakayama Medical University in Japan between May 2016 and May 2023. Patients with insufficient follow-up (<6 months) were excluded from the study. Eligible patients were categorized into one of the following three assessment groups: ‘good’ (improvement of palpebral fissure height without laterality, MRD-1Margin reflex distance-1 gap between right and left side < 0.5mm), ‘fair’ (improvement of palpebral fissure height with laterality) or ‘poor’ (poor improvement of palpebral fissure height). Thirty-five eyes in 25 patients were treated with the retroauricular fascia graft. The mean postoperative follow-up was 27 months. Eight patients were classified as good (32%), 15 as fair (60%), and two as poor (8%). Two patients (8%) had postoperative lagophthalmos. No patients had eyelash inversion, tarsal deformity or recurrence of ptosis recurrence. Scars along the edge of the hairline were inconspicuous and there were no hypertrophic scars. Functional reconstruction of the eyelids using the retroauricular fascia graft technique is described here for the first time. This graft technique may be a useful alternative for frontalis suspension surgery because it can be harvested with easy access and without leaving conspicuous scars.

Comparison of temporalis fascia and cartilage graft over-under myringoplasty for repairing large perforations

ObjectiveThe objective of this study was to compare the operation time, graft success, audiometric outcomes and complications of over-under technique using a temporalis fascia (TMF) and cartilage grafts for the repair of large perforations. Study designRandomized controlled trial. Materials and methods80 large perforations >2 quadrants of eardrum were prospectively randomized to undergo TMF over-under technique group (TFON, n = 40) or cartilage-perichondrium over-under technique group (CPON, n = 40). The graft success rate, audiometric outcomes, and complications were compared among two groups at 12 months. ResultsThe mean operation time was 56.8 ± 4.2 (range:52–71) min in the TFON group and 37.9 ± 2.8 (range: 31–47) min in the CPON group (P < 0.001). The lost follow-up rate was 3 (7.5 %) patients in the TFON group and 2 (5.0 %) patient in the CPON group (P = 0.644). Finally, 37 patients in the TFON group and 38 patients in the CPON group were included in this study. The graft infection rate was 2 (5.4 %) patients in the TFON group and 2 (5.3 %) patient in the CPON group (P = 0.626), all the graft infection resulted in the residual perforation. The remaining residual perforation was 2 (5.4 %) patients in the TFON group and 1 (2.6 %) patient in the CPON group; the re-perforation was 3 (8.1 %) patients in the TFON group and 0 (0.0 %) patient in the CPON group. The graft success rate was 81.1 % (30/37) patients in the TFON group and 92.1 % (35/38) patient in the CPON group. The mean preoperative and 12-month postoperative ABGs were significantly different in any group (P < 0.01). However, there were no significant difference among two groups regardless of pre-or post-ABGs or ABG closure. No lateralization of the graft or blunting was noted in any group. Four (10.8 %)patients developed atelectasis and one (2.7 %) developed the EAC scarring in the TFON group. Graft cholesteatomas was found in 2 (5.4 %) patients in the TFON group and in 5 (13.2 %) patients in the CPON group (P = 0.449). Three (8.1 %) patients had temporary hypogeusia in the TFON group. ConclusionAlthough temporalis fascia graft over-under technique obtained similar graft success rates and hearing outcomes for large chronic perforations to the cartilage-perichondrium over-under technique, temporalis fascia graft technique prolonged the operation time and increased the re-perforation and graft atelectasis. Nevertheless, the graft cholesteatomas were comparable among two techniques.

Radiation crosslinking and grafting of chitosan: Conversion of biowaste to an efficient adsorbent for removal of cationic dyes

By the mutual radiation grafting technique using Co60 gamma radiation, a novel anionic adsorbent “CRChitosan-g-SSS” was developed where in p-Sodium Styrene Sulphonate was covalently grafted onto crosslinked chitosan backbone. The synthesized radiation-grafted adsorbent was tested for the adsorptive removal of cationic dyes: methylene blue, malachite green and Congo red from aqueous solutions. The adsorbed amount of the respective dyes was 89.12, 73.13, and 29.14 (mg/g) respectively, which could be better described with Langmuir isotherm and pseudo-second-order reaction according to the correlation coefficient values, indicating favorable and feasible adsorption. Various factors influencing the adsorption capacity of“CRChitosan-g-SSS” like initial dye concentration, contact time, solution pH, and temperature were also studied. Different thermodynamic parameters such as standard free energy, standard enthalpy, and standard entropy were calculated which revealed the adsorption process to be exothermic and spontaneous. The radiation-grafted anionic adsorbent showed promising properties for the removal of toxic cationic dyes (i.e. Methylene blue, Malachite green, and Congo red).

Supplemental feeding coupled with different grafting techniques ensures better quality of queen honey bees

The quality of queens (Apis mellifera L.) is essential for the maintenance and development of A. mellifera honey bee colonies and can be obtained in several ways. However, a combination of different techniques can facilitate this process. This research was carried out to evaluate the Africanized honey bee queen production with the supply of fermented and unfermented additives using the techniques of single and double larvae grafting through assessment of morphometric characteristics, ovarian histology and supplement consumed by colonies. The queens were produced in 30 colonies: one group without supplemental feeding, one with fermented, and one with non-fermented supplemental feeding, with two grafting techniques. The use of unfermented supplements and the double grafting technique improved the quality of queen honey bees (p < 0.05). Also, the highest supplement consumption occurred when colonies were stimulated to produce queens. Therefore, the results shown herein are relevant for improving production processes and the quality of queen bees.

The comparison of a slightly modified geometrical principles based Peyronie’s plaque’s incision and grafting technique and the non-geometrical surgical techniques: A long-term single-centre experience

The comparison of a slightly modified geometrical principles based Peyronie’s plaque’s incision and grafting technique and the non-geometrical surgical techniques: A long-term single-centre experience

Ultrasound-guided Fat Graft of the Obliques-Serratus Complex.

The idea of the anterolateral thoracic musculature in men during the contour procedure is very limited, particularly in terms of surgical techniques that improve its appearance and aesthetics. Therefore, this study aimed to describe a technique of deep definition liposuction with intramuscular grafting of the serratus external oblique muscle complex. A retrospective case series of a total of 11 cases of male patients aged between 29 and 60 years in the year 2022 is presented. These patients underwent body contouring surgery and subsequently underwent ultrasound-guided intramuscular fat grafting in the serratus external oblique complex. As part of the study, measurements were taken before and immediately after surgery. The data were stored in a database and analyzed with the statistical software SPSS, v23.0. The patients were aged between 29 and 60 years, with a mean age of 38.3 years (±8.5). All cases had a body mass index of 30. Results were matched preinfiltration and postinfiltration; These results were subjected to statistical validation using the Student t test for related samples, and statistically significant differences were obtained in all the measures tested. The technique of fat grafting in the oblique-serratus complex allows for increasing muscle thickness. The measurements were made only immediately after the infiltration; it is important in the future to show the long-term follow-up. No adverse events occurred during the study.

Telosma mosaic virus: An emerging plant RNA virus causing production loss in passion fruit across Asia

AbstractTelosma mosaic virus (TeMV) is a highly infectious and rapidly spreading virus that infects a variety of natural hosts, with passion fruit (Passiflora edulis) being its primary host across parts of Asia. Symptoms of TeMV, which seriously threatens passion fruit production worldwide, include mosaic, deformities and lignification of fruit. We present here a review of the current state of knowledge of TeMV, including its structural characteristics, natural and experimental host range, symptoms and detection, and provide insights into control strategies. The mode of transmission of TeMV remains unclear, but it can be mechanically transmitted through grafting, cuttings and other artificial asexual propagation techniques, which unfortunately constitute the primary means of propagation in the passion fruit industry. Moreover, increasing detection rates of TeMV indicate that this virus probably causes more serious losses to the passion fruit industry than previously reported. No systematic control strategy for TeMV infection currently exists, and no TeMV‐resistant passion fruit varieties are currently available. As a speedy, short‐term solution for dealing with TeMV infection in the absence of a long‐term solution, we propose rapid plant propagation through virus‐free plant tissue culture techniques that can generate a substantial number of virus‐free passion fruit seedlings.

Augmentation of the Anterior Cruciate Ligament Using the Peroneus Longus: Description of the Surgical Technique

Background: The quadruple graft from the hamstring tendons has become a widely used option in the reconstruction of the anterior cruciate ligament (ACL), however, this graft may not have the desirable diameter for the reconstruction, increasing the risk of re-rupture. In this context, the peroneus longus tendon graft appears as an option to complement other grafts, transforming a thin quadruple graft into a sextuple graft. Indications: The sextuple graft technique for ACL reconstruction is used in patients who have a quadruple graft with a diameter of less than 8 mm, and due to its length, it is not possible to make a quintuple graft, for example. Technique Description: Initially, the hamstring tendons are removed with the aid of a tenotome. After that, the anterior half of the peroneus longus tendon is identified and removed. On the back table, the definitive graft is prepared so that we have a sextuple graft with a diameter greater than 8 mm. Finally, the ACL reconstruction is performed anatomically using an adjustable loop device in the femur and an interference screw in the tibia. Results: In our experience with patients who have a hamstring graft diameter of less than 8 mm, we obtained an average increase of 1.8 mm in graft diameter when augmentation was performed with the anterior half of the peroneus longus. Discussion: Grafts less than 8 mm in diameter are at increased risk of rupturing and failure of surgical treatment of the ACL injury. The surgeon must be prepared to make a quintuple or sextuple graft, but in some patients, the tendons are short or there is no availability of a tissue bank, making this practice impossible. The use of the anterior half of the peroneus longus to perform graft augmentation is safe, causing almost no morbidity to the donor area and is easily accessible during the procedure, making it an excellent option for increasing the diameter of thin grafts. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form.

Development of a Semifascicle Graft Technique to Bridge Peripheral Nerve Defect: A Case Report and Animal Study.

Autologous nerve grafting, the criterion standard for bridging peripheral nerves, can cause complications at the donor site. We investigated a novel approach to reconstruct the nerve gap with a split cross-sectional unmatched semifascicle autograft, which was harvested from the distal part of the injured nerve. A patient diagnosed with left-sided frontal branch facial nerve dissection underwent nerve bridging emergency surgery using a semifascicle nerve graft. A sciatic nerve model was used to validate the feasibility and mechanism of this method. Male Sprague-Dawley rats (n = 36) were randomized into (A) intact fascicle, (B) semifascicle, and (C) semifascicle + conduit groups and further subdivided into 4- and 8-week groups for histological analysis of the neurotissue area, fibers, and Schwann cells. The 8-week groups underwent weekly pain and temperature tests; the wet weight of the gastrocnemius muscle was measured after euthanasia. The frontalis of the patient's injured side exhibited movement at 2 months postsurgery and recovered a symmetrical appearance at 13 months. Group A exhibited more neurotissue areas and fibers than groups B and C at week 4; group B had more neurotissue than group C. Group A had greater neurotissue areas than groups B and C at week 8; groups B and C exhibited no differences. The groups displayed no differences regarding nerve fiber, pain, and temperature analysis at week 8. Muscle wet weight of groups A and B exhibited no differences and was higher than that of group C. We demonstrated the clinical translational value of semifascicle nerve grafts; the injured site was both the donor and recipient, thereby avoiding donor site damage and associated complications.

Re-tensioning Anterior Cruciate Ligament Reconstruction Using an Adjustable Femoral Button

Background: Despite advancements in surgical techniques for anterior cruciate ligament (ACL) treatment, persistent functional impairment, reduced quality of life, and limited physical activity participation continue to be common after postoperative rehabilitation. We modify the traditional ACL reconstruction method by using hamstring tendons grafts and re-tensioning them. Indications: This procedure is indicated for patients undergoing ACL reconstruction surgery with soft tissue grafts, utilizing femoral fixation with an adjustable button and tibial fixation with an interference screw. Technique Description: We employ hamstring grafts for ACL reconstruction and perform femoral fixation using an adjustable button. Initially, we pull the graft approximately 10 mm less than the length of the thickest tunnel drill. This allows for subsequent graft traction after tibial fixation. Following tibial fixation, we pull the graft proximally, inserting it a few millimeters further into the femoral tunnel. This re-tensioning increases tension and enhances physical examination results. In addition, we incorporate the braid graft technique to augment the graft's final thickness. Results: This technique yields reduced postoperative residual laxity during physical examinations. Our institution's ethics committee is currently reviewing a clinical study comparing functional outcomes with traditional techniques. Discussion/Conclusion: The ACL re-tensioning technique is easily implemented and involves a subtle modification to the traditional approach, allowing for graft re-tensioning and diminishing the risk of residual laxity post-interference screw fixation. This approach acknowledges that insertion of the interference screw can inadvertently reduce graft tension, counteracting the tension applied during fixation. Consequently, this technique is expected to yield superior clinical outcomes.