Preparation of the Graft

The graft is taken to the graft master on the back table. It is laid out, measured, and the muscle removed with the periosteal stripper. The ideal is to have four bundles of graft, 10 cm in length. The graft is folded over and leader sutures are placed in each end. The two tendons are

Figure 6.37. A small band from the gastrocnemius may kink the tendon causing the tendon stripper to cut it off short when it is advanced.
Figure 6.38. The completed harvest of the semitendinosus tendon.
Figure 6.39. The tendons are folded over a suture.

folded over the number 5 Ti-Cron suture (Sherwood Medical, St. Louis, MO) (Fig. 6.39). The ends of the tendons are secured with two number 2 Ti-Cron suture (Fig. 6.40). The sutures are placed into the tendon over a length of 3 cm. This serves to act as a marker, when we are positioning the graft in the tunnels.

The proximal end of the graft is whipstitched together with a number 2 Ti-Cron suture (Fig. 6.41). This prevents the graft from wrapping up when the screw is introduced. The stitch is done over 3 cm to mark the length of graft in the femoral tunnel. The physician should mark 3 cm from the end with a blue skin marker pen.

Figure 6.40. The distal ends of the tendon are whipstitched stitched together.

Figure 6.40. The distal ends of the tendon are whipstitched stitched together.

Figure 6.41. The proximal ends are also whipstitched together.

The final appearance of the prepared four-bundle, "Y"-hamstring graft is shown in Figure 6.42. The graft is then sized to the half size with a sizing cylinder (Fig. 6.43).

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