Hamstring graft diameter above 7 mm has a lower risk of fail
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The current systematic review and meta-analysis analysed the association of ACLR failure with the diameter of hamstring autografts. Multi-stranded hamstring-tendon autografts have been widely used for anterior cruciate ligament reconstruction (ACLR) surgeries. Recently, smaller diameter hamstring autografts have been linked with the risk of failure or graft rupture.

A systematic search of three major scientific databases was conducted to identify studies that presented ACLR failure-related outcomes with different diameters of hamstring autografts. The pooled data from the included studies were analysed to investigate the association between ACLR failure and the cut-off diameters of 6, 7, 8, and 9 mm. Subgroup analyses based on the level of evidence and follow-up duration were also performed at each cut-off diameter.

--Of the 2282 studies screened, 16 reported failure rates with hamstring autografts of different diameters, 15 of which were included in the meta-analysis.

--A graft diameter?more than?7 mm was associated with significantly lower ACLR failure rates than a graft diameter?less than?7 mm, based on pooled data of 19,799 cases.

--Age?less than?20 years and higher physical activity were associated with significantly higher ACLR failure rates.

In particular, the hamstring graft diameter for ACLR should be more than 7 mm considering the significantly higher failure rates with graft diameters less than 7 mm.

Source: https://link.springer.com/article/10.1007/s00167-021-06503-0