Anthropometric Predictprs Of Quadruple Hamstring Graft...

ANTHROPOMETRIC PREDICTPRS OF QUADRUPLE HAMSTRING GRAFT DIAMETER FOR ACL RECONSTRUCTION Naiyer Asif INTRODUCTION Among ligament reconstruction, the anterior cruciate ligament (ACL) is the most commonly reconstructed ligament of the knee. Many graft options are available for ACL reconstruction. Bone–patellar tendon–bone autograft has rigid fixation and has bone-to-bone healing, but it has donor site morbidity, among the complications ,anterior knee pain is the most common. The â€Å"quadrupled hamstring autograft† is obtained by harvesting the semitendinosus and the gracilis tendons at the pes anserinus and then folding them over twice to create 4 strands. Failure, however can be prevented using a graft that is significantly stronger than the native ACL, and graft strength has been found to be directly propotional to the cross-sectional area of the graft. Scott and Insall concluded that the length of normal ACL is 38mm (25–41mm) and the width is 10mm (7–12mm), on average In order to have a optimal 7cm quadrupled graft construct for ACL reconstruction (2cm in the femoral tunnel, 3cm intra articular, and 2cm in the tibial tunnel), it is essential to obtain a minimum tendon length of 28cm (ranged from 28 to 30cm) and it should have a minimum thickness of 7mm. Grafts used for ACL reconstructions which have smaller thickness have been shown to be weaker graft length could also inï ¬â€šuence the thickness by multiple looping. Sometime harvesting an adequately sized hamstring graft may not