Author(s)

A. Sideris^1,2,3, A. Hamze¹, N. Bertollo¹, D. Broe^1,2,3, WR Walsh^1,2,3

¹Surgical and Orthopaedic Research Laboratories, Prince of Wales Hospital, Randwick, New South Wales, Australia.
²Prince of Wales Clinical School, UNSW Medicine, University of New South Wales, Randwick, New South Wales, Australia.
³Prince of Wales Orthopaedic Department, Prince of Wales Hospital, Randwick, New South Wales, Australia.

The Four-Strand Hamstring Tendon Autograft has been long established as the gold standard for surgical reconstruction of the Anterior Cruciate Ligament. Some studies have suggested wider grafts, such as a Five-Strand hamstring graft, may provide greater strength and a larger scaffold for incorporation of the graft into the bone tunnels, leading to greater postoperative anterior stability of the knee. 28 (n = 18 Four-Strand and n = 10 Five-Strand) patients with planned ACL reconstructive surgery by a single surgeon were recruited for this study. The KT-1000 Arthrometer (MED metric, CA, USA) was used to quantify AP translation in the subjects’ knees before (T0) and after surgery at 6 (T1) and 12 (T2) weeks. At 12 weeks there was significantly higher (p = 0.01) mean anterior laxity on Maximum Manual Test in the Five- Strand group (9.1 ± 1.7 mm) than the Four Strand Group (6.9 ± 2.3 mm). Further, there were significantly higher mean side-to-side differences (p = 0.01) on Maximum Manual Test in the Five-Strand cohort (5.1 ± 3.5 mm) compared to the Four-Strand cohort (1.9 ± 2.2 mm). A significantly larger positive mean change in anterior laxity (p = 0.02) from 6 - 12 weeks was evident in the Five-Strand group (1.4 ± 0.9) than the Four-Strand group (-0.3 ± 1.9 mm). No significant correlations were seen between graft widths and measures of anterior stability on KT-1000. This study illustrated that there was no benefit to using a Five-Strand Hamstring Tendon Autograft when compared to the gold standard Four-Strand Repair specifically with regards to anterior stability of the knee.

Anterior Cruciate Ligament, ACL, Anterior Cruciate Ligament Reconstructive Surgery, Anterior Cruciate Ligament Reconstruction, ACL Reconstruction, Five Strand Hamstring Tendon Autograft, Four Strand Hamstring Tendon Autograft, KT-1000, AP Translation, Knee

Sideris, A. , Hamze, A. , Bertollo, N. , Broe, D. and Walsh, W. (2017) Five Strand Hamstring Tendon Autograft for Anterior Cruciate Ligament Reconstruction Provides No Benefit over the Gold Standard Four Strand Repair for Anterior Stability of the Knee: A Prospective Cohort Study. Open Journal of Orthopedics, 7, 156-172. doi: 10.4236/ojo.2017.76018.