Hamstring autograft utilization in reconstructing anterior cruciate ligament: Review of harvesting techniques, graft preparation, and different fixation methods

Table 3 Hamstring graft preparation techniques: summary of results

Graft preparation
Ref.	Study design	Results/conclusion
Ardern et al[47], 2009	Systematic review	ST-GT autograft have a significantly higher deficit in isometric strength at knee flexion ≥ 70°. Significant standing knee flexion angle deficit in the ST-GT autograft group.
Sharma et al[46], 2015	Meta-analysis	ST-GT group had a significantly higher isokinetic hamstring strength deficit at 60°. ST-GT group had a significantly higher isometric hamstring strength deficit at 90°, 105°, 110°. ST-GT group had a significantly higher standing knee flexion angle deficit.
Chin et al[48], 2018	Meta-analysis	ST-GT group had a significantly increased s deficit in isokinetic peak torque when compared with ST group for flexion at 60°/s at 2-yr follow-up, and flexion at 180°/s at 1- and 2-yr follow-up.
Tashiro et al[49], 2003	RCT	ST-GT group had a significantly increased deficit in isokinetic peak torque measured at knee flexion 60°/s at 80°, 90°, 110° when compared with ST group at 18 mo postoperatively. ST-GT group had a significantly higher isometric hamstring strength deficit at 70° measured in sitting position at 18 mo postoperatively. ST-GT group had a significantly higher isometric hamstring strength deficit at 70° and 90° measured in prone position at 18 mo postoperatively. Both groups showed significant isometric and isokinetic strength deficit when compared to preoperative measures.
Nakamura et al[50], 2002	Consecutive sample, case–control study	ST-GT group had a significantly higher standing knee flexion angle deficit. Decreased isokinetic torque at 90° in both groups.
Hu et al[51], 2020	Retrospective comparative	ST-GT group had a significantly higher isometric hamstring strength deficit at 90° flexion. Significant difference in the KOOS pain score.
Adachi et al[52], 2003	Prospective review	ST-GT group had a significantly higher standing knee flexion angle deficit.
Yosmaoglu et al[53], 2011	Prospective review	ST-GT group had a significantly higher hamstring isokinetic flexion strength deficit at 60°/s.
Carter et al[54], 1999	RCT	No difference in isokinetic strength deficit between ST-GT and ST groups, measured at 180°/s and 300°/s. Majority of patients had activity limitation at 6 mo postoperatively.
Karimi-Mobarakeh et al[55], 2014	RCT	No difference in isometric strength deficit between ST-GT and ST groups, measured at 90° flexion, extension, adduction, or abduction. No difference in patient outcome measures between ST-GT and ST groups.
Gobbi et al[56], 2005	RCT	ST-GT group had a significantly higher hamstring isokinetic internal and external rotation strength deficit at 60°/s.
Inagaki et al[57], 2013	Prospective comparative	No difference in isokinetic strength deficit between ST-GT and ST groups, measured at 60°/s. No difference in anterior laxity, or knee ROM. No difference in patient reported outcomes.
Segawa et al[58], 2002	Prospective study	ST-GT group had a significantly higher hamstring isokinetic internal rotation at 120°/s and 30°/s.
Ardern et al[59], 2010	Retrospective comparative	No difference in isometric strength deficit between ST-GT and ST groups, at 30°, 90°, or 105°. No difference in isokinetic strength deficit between ST-GT and ST groups, measured at 60°, 90°, and 105° or 60°/s and 180°/s. No difference in standing nee flexion angle between ST-GT and ST groups.
Barenius et al[60], 2013	Retrospective study	No difference in isokinetic strength deficit between ST-GT and ST groups, at 20°, and 90° measured at 60°/s. No difference in isometric strength deficit between ST-GT and ST groups at 90°.
Lipscomb et al[61], 1982	Retrospective study	No difference in isokinetic strength deficit between ST-GT and ST groups, measured at 60°/s and 240°/s.

ST-GT: Semitendinosus and gracilis; ST: Semitendinosus; RCT: Randomized control trial; KOOS: Knee osteoarthritis and outcomes score.