Anterior cruciate ligament reconstruction with six and eight‐strand hamstring tendon autografts produces adequate graft dimensions and functional outcomes: A systematic review
Bibliographic record
Abstract
PURPOSE: This study aims to summarize the graft dimensions, failure rates, return-to-sport rates and patient-reported outcome measures (PROMs) following anterior cruciate ligament reconstruction (ACLR) with six or eight-strand hamstring tendon autografts (6SHG or 8SHG). METHODS: Three databases were searched from inception to 12 February 2024. The authors adhered to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. All clinical studies reporting patient demographics, objective clinical outcomes and PROMs following ACLR with 6SHG or 8SHG were included for data synthesis. PROMs included the International Knee Documentation Committee (IKDC), Lysholm and Tegner scores. RESULTS: Thirteen studies comprising 1103 patients were included (mean age: 30.6 years). The transtibial technique was used in all studies, except one study using anatomic ACLR (n = 38), and one study using transtibial and all-inside ACLR (n = 41). Eight studies comprising 512 patients used 6SHG, four studies comprising 507 patients 8SHG and two studies comprising 97 patients used either. Mean graft diameters ranged from 8.0 to 9.2 mm (6SHG) and 9.1 to 9.9 mm (8SHG). Mean graft lengths for 49 6SHG patients ranged from 60.0 to 83.3 mm. The failure rate for 817 patients (6SHG or 8SHG) was 4.8% (0.0%-20.0%). The return-to-sport rate for 112 patients (6SHG or 8SHG) was 75.9% (69.7%-100.0%). Mean IKDC, Lysholm and Tegner scores for 6SHG or 8SHG were 88.4 (86.1-96.3), 91.7 (90.4-96.5) and 6.9 (6.5-7.3), respectively. CONCLUSIONS: Both 6SHG and 8SHG produced graft diameters <8 mm. Data regarding PROMs suggested good patient satisfaction based on established criteria. Re-rupture and return-to-sport rates were 4.8% and 75.9%, respectively. LEVEL OF EVIDENCE: Level IV.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.009 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".