How to Increase Hamstring Graft Diameter for ACL Reconstruction

Dave Duffy demonstrates a simple technique for producing a hamstring graft suitable for ACL reconstruction.

Currently there is considerable debate at orthopaedic meetings about the relative merits of different graft choice (hamstrings, patella or quadriceps tendon) when performing an ACL reconstruction.

One fundamental difference between the graft choices is that the surgeon has control over the size of the patella or quadriceps tendon graft harvested but doesn’t when using the hamstrings. Therefore it is essential that a surgeon has a reliable technique for producing a hamstring graft of sufficient diameter, especially if the harvested tendons are small.

This video demonstrates a simple technique for increasing the hamstring graft diameter with a 6 strand construct. It allows the use a variable loop suspensory device whilst still maintaining the tibial attachment of the hamstrings to provide a secondary point of fixation.

Notes for the squeamish: This video features live footage of a hamstring graft harvesting procedure. Virtually no blood is visible.

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