Comparing the Width of Hamstring Grafts Prepared Using Wet and Dry Gauze Methods in Anterior Cruciate Ligament Reconstruction Surgery

The anterior cruciate ligament surgery commonly uses a hamstring tendon. The hamstring grafts are usually prepared by wrapping in a wet gauze under tension. 

The placement of a hamstring tendon in a dry gauze affects the size of the graft, without any change in its collagen volume. The present study aimed to prove that the preparation method could affect the hamstring graft width.

A total number of 32 patients who had undergone the anterior cruciate ligament reconstruction were enrolled in this analytical descriptive study. Initially, the width of the 4-layered extracted graft was measured using the sizer system, after placement under traction. Then, 16 patients were operated on, based on the dry gauze preparation method, and the other 16, based on the wet gauze preparation method. The grafts were remeasured after traction. Six months after the surgery, all patients received a clinical evaluation, in which the integrity of the graft was evaluated based on clinical criteria. 

The Mean±SD width of the 4-layered extracted grafts was 7.44±0.54 mm and 7.41±0.33 mm in the dry gauze and wet gauze groups, respectively. However, these values did not significantly differ (P=0.96). After traction, the Mean±SD graft width of the dry gauze group was reduced to 6.97±0.62 mm. The traction led to no change in the graft width of the wet gauze group. The changes in the graft size significantly differed between the two groups (P=0.032). Moreover, 4 patients (25%) exhibited no certain endpoint in the Lachman test, also, the pivot shift-test was positive in 5 patients (31.2%).

The hamstring graft preparation technique affects the tunnel graft size. Besides, the use of dry gauzes procures the need for a narrower tunnel in the tibia and femur.