Comparison of Braided and Nonbraided Hamstring Tendon Grafts in ACL Reconstruction: Impact on Graft Thickness, Rerupture Rates, and Clinical Outcomes

Purpose: To compare braided and nonbraided hamstring tendon grafts in anterior cruciate ligament (ACL) reconstruction, specifically examining graft thickness, rerupture rates, and clinical outcomes, in order to assess whether braided grafts offer measurable advantages. Study Design: Cohort study; Level of evidence, 3. Methods: test for continuous data and Fisher exact test for categorical data. Kaplan-Meier curves were used descriptively to illustrate rerupture-free survival. Results: = .16; fragility index = 1). Functional outcomes (KOOS, IKDC, Lysholm) improved over time in both groups, with no statistically significant between-group differences at 2 years. Conclusion: Braided hamstring tendon grafts reliably achieved increased graft thickness, whereas the lower rerupture rate was numerical only, was not statistically significant, and was statistically fragile. Braiding can be considered an intraoperative option to optimize graft diameter without compromising clinical outcomes, but the findings should be interpreted as exploratory.