A Comparative Study of Braided versus Standard Preparation of Autologous Hamstring Graft in Anterior Cruciate Ligament Reconstruction

Background: Anterior cruciate ligament (ACL) reconstruction commonly employs autologous hamstring grafts, with varioustechniques used for graft preparation. Standard 4-strand grafts are widely accepted; however, braided grafts have been proposed tooffer improved biomechanical properties and graft fixation. This study aims to compare the clinical and functional outcomes ofbraided versus standard hamstring graft preparations in ACL reconstruction. Methods: In this prospective randomized study, 171 patients undergoing primary ACL reconstruction were assigned to two groups:group A (standard graft, n = 92) and group B (braided graft, n = 79). Intraoperative data such as graft length and diameter wererecorded. Clinical and functional outcomes were evaluated using International Knee Documentation Committee (IKDC) andLysholm scores and knee range of motion (ROM) at 2 weeks, 6 weeks, 3 months, and 6 months postoperatively. Results: The braided graft group demonstrated a larger mean graft diameter (P = 0.492) but decreased graft length (P = 0.028).During follow-ups till 6 months, both groups showed progressive improvement but no significant difference between the twogroups with respect to knee ROM, IKDC, or Lysholm scores. Difference in complications was statistically insignificant. Conclusion: The study suggests that both standard and braided hamstring grafts are effective options for ACL reconstruction,yielding comparable short-term clinical outcomes. However, the braided technique demonstrates potential advantages in terms ofincreased graft thickness and uniform fixation. While these findings are promising, further in vivo studies and long-term clinicaltrials are necessary to validate the superiority of the braided graft technique in ACL reconstruction