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Hamstring graft was used to reconstruct the MPFL.
Hamstring graft preparation using a needleless suture loop.
Multiple anterolateral femoral cortex perforations were reported as the etiology for the fracture reported 7 months following a patellar tendon ACL reconstruction by Weiner et al. [11] in 1996, and 5 months following quadrupled hamstring graft ACL reconstruction by Sheps et al. [12] in 2006.
As it was documented by Forssblad et al. [ 38], patellar tendon graft is superior to hamstring graft in terms of the cost of the ACL reconstruction.
Several different methods have been described to reconstruct the MPFL with hamstring graft, and variation also occurs between tunnel placement and graft fixation methods.
The two graft options were equally represented among the dropouts, that is, 4 ACL-reconstructions with hamstring graft and 2 ACL-reconstructions with patella tendon graft in the HRT- and LRT-groups, respectively.
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Most operative techniques use hamstring grafts fixed with bone tunnels and/or anchors on the patella.
Some national variations do, however, exist: surgeons in Sweden and Denmark prefer hamstring grafts to a much greater extent than surgeons in Norway.
At one year after surgery Clatworthy et al. observed a 73%% increased tibial tunnel diameter for hamstring grafts compared to a 2%% decrease for bone-patella tendon bone grafts [ 3].
Quadriceps tendon grafts have been shown to provide good strength and low donor site morbidity, therefore being an alternative to hamstring grafts even in primary ACL reconstruction [ 5, 11, 12].
An exercise program with early open-chain exercises (4 weeks postoperatively) will lead to more laxity with hamstring grafts than late open-chain exercises (12 weeks postoperatively) (Heijne and Werner 2007).
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