Principles for using hamstring tendons for anterior cruciate ligament reconstruction

The use of autogenous hamstring tendon as a graft source for anterior cruciate ligament (ACL) reconstruction continues to gain in popularity. The low harvest morbidity and excellent biomechanical graft properties coupled with improved fixation of soft tissue grafts are all reasons for excellent clinical outcomes of ACL reconstruction using hamstring tendons. In addition, surgeon awareness of the complications associated with poor tunnel placement and more exacting tunnel placement techniques help prevent roof and posterior cruciate ligament impingement and contribute to the successful outcomes of hamstring ACL constructs.