Abu Dhabi, United Arab Emirates.
Arthroscopy. 2018 Sep;34(9):2641-2646. doi: 10.1016/j.arthro.2018.06.014.
The concept of a five-strand hamstring tendon autograft for anterior cruciate ligament reconstruction is not new. The concept of a five-strand hamstring tendon autograft was largely ignored until recent studies showed higher failure and revision rates for hamstring ACL reconstructions performed with graft diameters less than 8 mm. In the majority of patients in the United Arab Emirates, four-strand hamstring tendon autografts result in a graft diameter between 6.5-7.5 mm. As a result, since 2006, I have completely abandoned using four-strand hamstring tendon autografts in favor of five-and six-stranded hamstring tendon autografts for ACL reconstructions. The key to performing five-or six-strand hamstring tendon autografts lies in the ability to triple the semitendinosus tendon and in the case of six-strand hamstring tendon grafts, the gracilis tendon. Although, five-and six-strand hamstring tendon autografts can increase the diameter of hamstring tendon ACL grafts, the question of whether these grafts will reduce failure and revision rates remains unanswered.
对于前交叉韧带重建，使用五股腘绳肌腱自体移植物的概念并不新鲜。直到最近的研究表明，对于直径小于 8 毫米的腘绳肌腱 ACL 重建，失败和翻修率更高，五股腘绳肌腱自体移植物的概念才被广泛关注。在阿拉伯联合酋长国的大多数患者中，四股腘绳肌腱自体移植物的直径在 6.5-7.5 毫米之间。因此，自 2006 年以来，我完全放弃了使用四股腘绳肌腱自体移植物，转而支持使用五股和六股腘绳肌腱自体移植物进行 ACL 重建。进行五股或六股腘绳肌腱自体移植物的关键在于能否将半腱肌腱三倍化，对于六股腘绳肌腱移植物，还在于能否将股薄肌腱三倍化。尽管五股和六股腘绳肌腱自体移植物可以增加腘绳肌腱 ACL 移植物的直径，但这些移植物是否会降低失败和翻修率的问题仍未得到解答。
