Hamstring graft for ACL reconstruction: does size matter?

This letter is in response to the commentary entitled, “Advances in anterior cruciate ligament reconstruction techniques” recently published in the Annals of Translational Medicine. The authors of this editorial comment on our article published in the March 2016 issue of The Journal of Bone and Joint Surgery which examined how the diameter of soft-tissue hamstring ACL grafts significantly changes after applying circumferential compression to the grafts. We thank the authors for highlighting our article as an important contribution in the field of ACL reconstruction. The use of hamstring grafts for ACL reconstruction has been increasing worldwide and while there is ample literature supporting the use of these grafts (1-3), we sought to highlight further the nuances associated with this surgical technique.