Richardson MW, et al. - Investigators researched data to examine the alternative graft constructs for all-inside anterior cruciate ligament (ACL) reconstruction in the event that the semitendinosus harvested was either too narrow or too short to make a graft larger than 8 mm. The button-fixation 4-strand graft was the only graft which revealed significant biomechanical differences during the cyclic phase of testing when compared with the traditional 4-strand graft. It was characterized by lower force at 3 mm of displacement (74 ± 34 N vs 122 ± 13 N) and 5 mm of displacement (122 ± 35 N vs 172 ± 3 N). They noted that the ultimate force was significantly lower for both the 6-strand graft (491 ± 186 N) and button-fixation 4-strand graft (326 ± 27 N) than for the traditional 4-strand graft (778 ± 176 N) during failure loading.