Hamstring Autograft versus Patellar Tendon Autograft for ACL Reconstruction: Is There a Difference in Graft Failure Rate? A Meta-analysis of 47,613 Patients

Samuelsen, Brian T.; Webster, Kate E.; Johnson, Nick R.; Hewett, Timothy E.; Krych, Aaron J.

doi:10.1007/s11999-017-5278-9

Cited by 296 publications

(265 citation statements)

References 51 publications

Supporting

Mentioning

252

Contrasting

Unclassified

Order By: Relevance

“…14 Similar advantages of BTB have not been demonstrated in the meta-analyses or systematic reviews comparing the outcomes of BTB and hamstring tendon autografts. 39,40 The potential advantage of a combined ACLþALL graft has been attributed to load sharing of the ALL 41 with the reconstructed ACL. Furthermore, it has also been reported that at lateral exploration of apparently isolated acute ACL injured knees, injury to the anterolateral structure is identified in approximately 90% of cases.…”

Section: Discussionmentioning

confidence: 99%

Combined Anterior Cruciate and Anterolateral Ligament Reconstruction in the Professional Athlete: Clinical Outcomes From the Scientific Anterior Cruciate Ligament Network International Study Group in a Series of 70 Patients With a Minimum Follow-Up of 2 Years

Rosenstiel

Praz

Ouanezar

et al. 2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

Purpose: To evaluate clinical outcomes in professional athletes after combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction at a minimum follow-up of 2 years. Methods: A retrospective analysis of prospectively collected data from the Scientific Anterior Cruciate Ligament Network International (SANTI) Study Group database was performed. All professional athletes who underwent primary combined ACL and ALL reconstruction between January 2011 and March 2016 were included. Patient assessment included physical examination, pre-and postoperative subjective and objective International Knee Documentation Committee (IKDC), Tegner activity scale, and Lysholm scores. Results: Seventy-two professional athletes underwent primary ACL and ALL reconstruction; 70 (97%) were available, with a mean follow-up of 3.9 years (range, 2-7). The preoperative side-to-side anteroposterior laxity difference was 7.1 AE 1.4 mm, and this decreased significantly after surgery to 0.4 AE 0.9 mm (P < .0001). Pivot-shift grade evolved from 16 grade I (22.8%) and 54 grade II or III (77.2%) preoperatively, to 66 absent pivot shift (94.3%) and 4 grade I (5.7; P < .001). By 1-year postoperatively, 60 athletes (85.7%) returned to professional sport, with a mean time interval of 7.9 months (range, 5-12). Preoperatively, the mean subjective IKDC was 56.1 AE 12.3, the Lysholm score was 48.4 AE 12.5, and the Tegner score was 9.3 AE 1. At final follow-up, the mean subjective IKDC was 90.5 AE 7.6 (P < .0001), the Lysholm score was 94.4 AE 7.5 (P < .0001), and the Tegner score was 8.8 AE 1.5 (P < .004). The objective IKDC evolved from 39 grade C (55.7%) and 31 grade D (44.3%) preoperatively to 65 grade A (92.9%) and 5 grade B (7.1%) (P < .0001). Eleven Patients (15,7%) underwent a subsequent ipsilateral reoperation including 4 (5.7%) revision ACL reconstructions. The risk of graft rupture was significantly higher in female patients (13.6% vs 2.1% in male patients; P ¼ .048). Conclusions: Combined ACL and ALL reconstruction is associated with excellent outcomes in professional athletes with respect to graft rupture rates, return to sport, knee stability, and reoperation rates after injury. Level of Evidence: Level IV, case series. See commentary on page 893 D espite a major focus on injury prevention, the rates of anterior cruciate ligament (ACL) rupture have remained relatively unchanged over the last 25 years. 1-3 ACL rupture continues to represent a devastating injury with potentially career-ending consequences for the professional athlete. Even for those

show abstract

Section: Discussionmentioning

confidence: 99%

Combined Anterior Cruciate and Anterolateral Ligament Reconstruction in the Professional Athlete: Clinical Outcomes From the Scientific Anterior Cruciate Ligament Network International Study Group in a Series of 70 Patients With a Minimum Follow-Up of 2 Years

Rosenstiel

Praz

Ouanezar

et al. 2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

show abstract

“…In addition, a recent randomised controlled trial with large population comparing BPTB, SB and DB hamstring tendon grafts showed that more traumatic reinjuries occurred with SB and DB hamstring grafts compared with BPTB. However, no recent systematic reviews or meta-analyses of randomised or prospective studies showed any difference in the revision rate between hamstrings and BPTB grafts,2 3 6 except one most recent meta-analysis showing that hamstring tendon graft failed at a higher rate than BPTB graft 4. One large limitation of this study is, however, that most of the patients included in this study came from the Scandinavian registry study with the lowest Modified Coleman Methodology Score and those results factor heavily into the results (79.1%).…”

Section: Current State Of the Art: Graft Selectionmentioning

confidence: 99%

ACL graft selection: state of the art

Koga

Zaffagnini²,

Getgood

et al. 2018

Journal of ISAKOS

View full text Add to dashboard Cite

“…Several studies have shown that hamstring tendons are associated with higher retear rates, decreased knee flexion strength, and increased infection than both patellar tendon and quadriceps tendon grafts. [46][47][48][49][50][51] Consequently, in the young patients, active Service member, autograft reconstruction with hamstring tendons is often a secondary graft choice in the most high-risk patient populations. Patellar tendon autograft has become the preferred method of ACL reconstruction by military orthopaedic surgeons as it has repeatedly been shown to have the most secure fixation with low failure rates and high patient reported outcomes.…”

Section: Graft Considerationsmentioning

confidence: 99%

The Military ACL

Tennent

Posner

2018

J Knee Surg

View full text Add to dashboard Cite

Anterior cruciate ligament (ACL) injuries in the U.S. Military Service members have a 10-fold higher incidence than that of the general population due to the physically demanding aspects of military duties. Although some controversy exists on the specific techniques or reconstruction, these injuries are uniformly reconstructed due to the requirements of their occupation and the effect of these injuries on their future careers. As such, understanding the care of the military Service member's ACL may help optimize the care of the physically active injured knee.

show abstract

Hamstring Autograft versus Patellar Tendon Autograft for ACL Reconstruction: Is There a Difference in Graft Failure Rate? A Meta-analysis of 47,613 Patients

Abstract: Level III, therapeutic study.

Cited by 296 publications

References 51 publications

Combined Anterior Cruciate and Anterolateral Ligament Reconstruction in the Professional Athlete: Clinical Outcomes From the Scientific Anterior Cruciate Ligament Network International Study Group in a Series of 70 Patients With a Minimum Follow-Up of 2 Years

Combined Anterior Cruciate and Anterolateral Ligament Reconstruction in the Professional Athlete: Clinical Outcomes From the Scientific Anterior Cruciate Ligament Network International Study Group in a Series of 70 Patients With a Minimum Follow-Up of 2 Years

ACL graft selection: state of the art

The Military ACL

Contact Info

Product

Resources

About