Editorial Commentary: Gracilis-Sparing Anterior Cruciate Ligament Hamstring Graft Reconstruction Is Less Invasive Than Semitendinosus-Gracilis Graft Harvest, and Shows No Clinical Difference in Outcomes With Grafts Greater Than 8 mm in Diameter

Although patellar tendon grafts are most commonly used for anterior cruciate ligament reconstruction in the United States, hamstring autograft is most commonly used worldwide. Hamstring advantages include easy, quick harvest; low morbidity; ease of rehabilitation (compared with patellar tendon grafts); and relatively less pain. Historically, both the semitendinosus (ST) and gracilis are harvested, but by doubling, tripling, or quadrupling the ST to achieve an 8-mm graft, the gracilis can be spared, resulting in less knee flexion weakness. However, recent research has shown no clinically important difference between ST and ST-gracilis patient outcomes.