Arthroscopic single-bundle anterior cruciate ligament reconstruction with six-strand hamstring tendon allograft versus bone-patellar tendon-bone allograft

Abstract

II.

Laser-guided transtibial technique improved single-bundle reconstruction of anterior cruciate ligament

“…Recent studies showed that the thicker graft has a lower failure rate for ACL reconstruction [ 20 – 22 ]. However, the width of the grafts should be limited.…”

Hamstring Graft Preparation Techniques for Anterior Cruciate Ligament Reconstruction

“…Numerous different hamstring preparation techniques have been described in the literature. 9 , 23 There is, however, a scarcity of studies looking at superiority within hamstring graft types. Conte et al.…”

“…Furthering the argument that larger graft size leads to improved outcomes, the study by Dai et al. 9 showed that a 6-strand hamstring tendon autograft had decreased pivot shift, less graft failure rate, and improved KT-1000 outcomes when compared with a patellar tendon autograft. Although studies like these help to make the argument that larger graft size with more strands may lead to increased anteroposterior stability, they do not say anything regarding long-term outcomes, and rates of osteoarthritis.…”

“…Graft types, particularly hamstring ( Table 1 ) and patellar tendon grafts, have shown good results, and there is no strong evidence demonstrating the superiority of either graft type. 9 , 10 …”

Editorial Commentary: The Jury Remains Out on Hybrid Autograft-Plus-Allograft for Diminutive Hamstring Anterior Cruciate Ligament Autografts

“…There are several options as to reconciling this situation intraoperatively, including (1) abandoning the diminutive graft and using an all allograft concept, (2) using the autograft available and augmenting this with an allograft, or (3) using a 5-or 6strand construct if the semitendinosus is of appropriate size. 8,9 Leo et al reported on their use of a nonirradiated soft tissue allograft (tibialis anterior or tibialis posterior) to supplement the autograft harvested and achieve a minimum graft size. International Knee Documentation Committee and UCLA ACL quality of life scores demonstrated no statistical difference between the groups at a minimum of 2 years of follow-up.…”