Hamstring autograft versus patellar tendon autograft for anterior cruciate ligament reconstruction, which graft has a higher contralateral anterior cruciate ligament injury rate?

Zhou, Peng; Liu, Jun-Cai; Deng, Xiangtian; Li, Zhong

doi:10.1097/md.0000000000021540

Cited by 9 publications

(12 citation statements)

References 52 publications

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“…Zhou et al in a meta-analysis reviewing 5561 primary ACLR, reported an increased risk of contralateral ACL ligament rupture in patients receiving BPTB autograft (8.5%) compared to HT autografts (3.3%) p = 0.0004. 42 …”

Section: Registry Datamentioning

confidence: 99%

Current concepts in graft selection for anterior cruciate ligament reconstruction

et al. 2021

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Graft selection for anterior cruciate ligament reconstruction (ACLR) is important for optimizing post-operative rehabilitation, facilitating return to full sporting function and reducing the risk of complications. The most commonly used grafts for ACLR include hamstring tendon autografts, bone–patellar tendon–bone autografts, quadriceps tendon autografts, allografts and synthetic grafts. This instructional review explores the existing literature on clinical outcomes with these different graft types for ACLR and provides an evidence-based approach for graft selection in ACLR. The existing evidence on the use of extra-articular tenodesis to provide additional rotational stability during ACLR is also revisited. Cite this article: EFORT Open Rev 2021;6:808-815. DOI: 10.1302/2058-5241.6.210023

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Section: Registry Datamentioning

confidence: 99%

Current concepts in graft selection for anterior cruciate ligament reconstruction

et al. 2021

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“…In a study of female soccer players ( n = 90) that had undergone ACL reconstruction, with data available for a minimum of a 2-year follow-up, the outcomes for hamstrings autograft and bone-patellar tendon-bone autografts were very similar ( Britt et al, 2020 ). Notwithstanding, a meta-analysis of 5,561 patients undergoing ACL reconstruction found that hamstrings autografts were less likely than bone-patellar tendon-bone autografts to incur in a contralateral ACL rupture ( Zhou et al, 2020 ). The safety of surgical procedures and its effects on the specific injury addressed should not be disregarded ( Jain et al, 2014 ).…”

Section: Part 2: Anatomic and Physiologic Variations Of The Hamstrings And Potential Implications For Injury Riskmentioning

confidence: 99%

The Hamstrings: Anatomic and Physiologic Variations and Their Potential Relationships With Injury Risk

et al. 2021

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The incidence and recurrence of hamstrings injuries are very high in sports, posing elevated performance and financial-related costs. Attempts to identify the risk factors involved in predicting vulnerability to hamstrings injury is important for designing exercise-based programs that aim to mitigate the rate and severity of hamstrings injuries and improve rehabilitation strategies. However, research has shown that non-modifiable risk factors may play a greater role than modifiable risk factors. Recognizing non-modifiable risk factors and understanding their implications will afford the prescription of better suited exercise programs, i.e., that are more respectful of the individual characteristics. In a nutshell, non-modifiable risk factors can still be acted upon, even if indirectly. In this context, an underexplored topic is how intra and inter- individual anatomic and physiologic variations in hamstrings (e.g., muscle bellies, fiber types, tendon length, aponeurosis width, attachment sites, sex- and age-related differences) concur to alter hamstrings injuries risk. Some anatomic and physiologic variations may be modifiable through exercise interventions (e.g., cross-sectional area), while others may not (e.g., supernumerary muscle bellies). This apparent dichotomy may hide a greater complexity, i.e., there may be risk factors that are partially modifiable. Therefore, we explored the available information on the anatomic variations of the hamstrings, providing a deeper insight into the individual risk factors for hamstrings injuries and contributing with better knowledge and potential applications toward a more individualized exercise prescription.

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“…Sixteen of the studies reported the sample size of patients undergoing ACL rupture (ACLR) with a BPTB autograft, as well as the sample size of patients with an HT autograft [5][6][7][8][10][11]13,18,[21][22][25][26][27][28][29][30]. The remaining five reported a total number of patients [15][16]20,[23][24], one reported the total sample and specified the graft the majority received, but a small number remained unknown [19].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Another one reported a number of series [9] and three did not specify the sample size [12,14,17]. Twenty-one of the studies reported on short-term outcomes [5][6][7][8][9][10][11][12][13][15][16][17][18][19][21][22][23][24][25]27,30], four on long-term outcomes [14,20,[28][29], and another reported one on all three, short-, mid-, and long-term outcomes [26].…”

Section: Study Characteristicsmentioning

confidence: 99%

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A Systematic Approach for Stronger Documentation of Anterior Cruciate Ligament Graft Choice

Arida¹,

Mastrokalos²,

Panagopoulos³

et al. 2021

Cureus

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Numerous studies have focused on determining the optimal choice between the two most used anterior cruciate ligament (ACL) reconstruction autografts. In order to address this matter, we performed a systematic review of every meta-analysis published on the PubMed platform between 2001 and 2020, comparing the functional outcomes, the static stability parameters, as well as the postoperative and longterm complications of the patellar tendon (BPTB) autograft and hamstrings (HT). We retrieved a total of 26 meta-analyses that met our criteria, and the characteristics and outcomes of every meta-analysis, as well as subgroup analysis regarding the type of the study design, number of strands of HT autograft, and fixation method, were extensively recorded. The majority of the meta-analyses showed that there were no significant differences between BPTB and HT in terms of functional outcomes and static stability parameters while HT autografts seem to be superior to BPTB regarding kneeling pain and anterior knee pain. Other outcomes seem to be affected by the number of strands of the HT autograft, the fixation technique, and the type of study design, indicating superiority of the four-strand HT autograft with the use of an extra-cortical button fixation. Overall, there is no clear superiority of BPTB over HT autografts for ACL reconstruction, as both types present similar outcomes in the majority of postoperative parameters. Autograft selection should be individualized according to each patient's needs and more RCTs are warranted in order to reach safer results on the appropriate autograft type.

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Hamstring autograft versus patellar tendon autograft for anterior cruciate ligament reconstruction, which graft has a higher contralateral anterior cruciate ligament injury rate?

Cited by 9 publications

References 52 publications

Current concepts in graft selection for anterior cruciate ligament reconstruction

Current concepts in graft selection for anterior cruciate ligament reconstruction

The Hamstrings: Anatomic and Physiologic Variations and Their Potential Relationships With Injury Risk

A Systematic Approach for Stronger Documentation of Anterior Cruciate Ligament Graft Choice

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