ACL Reconstruction Basics: Quadruple (4-Strand) Hamstring Autograft Harvest Rachel M. Frank, M.D., Jason T. Hamamoto, B.S., Eamon Bernardoni, B.A., Gregory.

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ACL Reconstruction Basics: Quadruple (4-Strand) Hamstring Autograft Harvest Rachel M. Frank, M.D., Jason T. Hamamoto, B.S., Eamon Bernardoni, B.A., Gregory Cvetanovich, M.D., Bernard R. Bach, M.D., Nikhil N. Verma, M.D., Charles A. Bush-Joseph, M.D. Arthroscopy Techniques Volume 6, Issue 4, Pages e1309-e1313 (August 2017) DOI: 10.1016/j.eats.2017.05.024 Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 1 Intraoperative photograph (left leg) showing the location of the incision for semitendinosus and gracilis tendon harvest. Arthroscopy Techniques 2017 6, e1309-e1313DOI: (10.1016/j.eats.2017.05.024) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 2 Intraoperative photograph (left leg) showing the location of the sartorial fascia. Arthroscopy Techniques 2017 6, e1309-e1313DOI: (10.1016/j.eats.2017.05.024) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 3 Intraoperative photograph (left leg) showing the location of the semitendinosus and gracilis tendons after dissection free from the sartorial fascia. Arthroscopy Techniques 2017 6, e1309-e1313DOI: (10.1016/j.eats.2017.05.024) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 4 Intraoperative photograph (left leg) showing dissection of the gracilis from the sartorial fascia and from the semitendinosus, prior to harvesting. Arthroscopy Techniques 2017 6, e1309-e1313DOI: (10.1016/j.eats.2017.05.024) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 5 Intraoperative photograph (left leg) showing the use of the tendon stripper to harvest the gracilis tendon after whip-stitching the free end with a high-strength nonabsorbable suture (Ethicon). Arthroscopy Techniques 2017 6, e1309-e1313DOI: (10.1016/j.eats.2017.05.024) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 6 Intraoperative photograph (left leg) showing the use of the tendon stripper to harvest the semitendinosus tendon after whip-stitching the free end with a high-strength nonabsorbable suture (Ethicon); the gracilis tendon has previously been harvested. Arthroscopy Techniques 2017 6, e1309-e1313DOI: (10.1016/j.eats.2017.05.024) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions