Estimated diameter increase from a 4S to a 6S hamstring graft configuration – A cadaveric study

Purpose: Graft diameter in anterior cruciate ligament reconstructions has been shown to influence the risk of failure. It is therefore important to be able to adjust the graft configuration to modify the diameter. To measure the impact of a 6-strand (6S) hamstring autograft configuration on graft diameter compared to the standard 4-strand (4S) configuration. Methods: Cadaveric study on 33 knees, using the usual hamstring graft harvesting technique. Semitendinosus and gracilis tendons were harvested and their length, width, and diameter were measured in 4S and 6S configurations separately by three evaluators. Results: 6S configuration leads to a median increase of 1.5 (range: 0.0–2.0) mm in diameter compared to 4S (p