Anterior cruciate ligament reconstruction (ACLR) with hamstring autografts have demonstrated lower failure risk with larger graft diameters. The traditional graft construct consists of a doubled semitendinosus and gracilis tendons (4STG), with other techniques employing a quadrupled semitendinosus (4ST) configuration. This study examines the relationship between both hamstring autograft construct and graft size with adolescent revision risk. We hypothesize that there are similar revision risks for 4ST and 4STG grafts, with larger grafts correlating with lower failure risk.

Methods

A retrospective review was conducted for adolescent patients (ages 13-19) who underwent primary ACLR with hamstring autograft from 2013 to 2022. Data on demographics, graft characteristics, concurrent procedures, and subsequent revision surgery were obtained. 470 patients who underwent ACLR with hamstring autograft were included, with 447 classified into 4ST and 4STG configurations. Revision risk was compared between the 4ST and 4STG groups as well as by graft size (greater or less than 8.5 mm diameter) within the two groups.

Results

Overall revision risk for all 470-hamstring autograft ACLR’s was 9.8% (46/470 patients) with a mean 1.5-year follow-up. No significant difference in revision risk was found between patients reconstructed with 4ST (10.6%) versus 4STG (10.0%) grafts (p=0.88). A substantial majority of all grafts (78%) exceeded 8 mm in diameter. Mean graft diameter was significantly larger in the 4ST group compared to the 4STG group (9.0 mm vs 7.9 mm, p<0.001). Graft size did not significantly affect failure risk in either group.

Conclusion

No significant difference in ACL revision risk was observed between hamstring autograft configurations in adolescents. Graft size was not associated with revision risk in this cohort with a relatively large mean graft size.

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No Difference in ACL Reconstruction Revision Risk with Different Hamstring Autograft Configurations in Adolescent Patients

No Difference in ACL Reconstruction Revision Risk with Different Hamstring Autograft Configurations in Adolescent Patients

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No Difference in ACL Reconstruction Revision Risk with Different Hamstring Autograft Configurations in Adolescent Patients

No Difference in ACL Reconstruction Revision Risk with Different Hamstring Autograft Configurations in Adolescent Patients

Objective

Methods

Results

Conclusion