Graft Selection for Anterior Cruciate Ligament Reconstruction: A Level I Systematic Review Comparing Failure Rates and Functional Outcomes

Keith R. Reinhardt, Iftach Hetsroni, Robert G. Marx

Research output: Contribution to journalReview articlepeer-review

Abstract

Tear of the anterior cruciate ligament (ACL) is the most common ligamentous injury of the knee. Reconstructing this ligament is often required to restore functional stability of the knee. Many graft options are available for ACL reconstruction, including different autograft and allograft tissues. Autografts include bone-patellar tendon-bone composites (PT), combined semitendinosus and gracilis hamstring tendons (HT), and quadriceps tendon. Allograft options include the same types of tendons harvested from donors, in addition to Achilles and tibialis tendons. Tissue-engineered anterior cruciate grafts are not yet available for clinical use, but may become a feasible alternative in the future. The purpose of this systematic review is to assess whether one of the popular grafts (PT and HT) is preferable for reconstructing the ACL. For this objective, the authors selected only true level I studies that compared these graft choices in functional clinical outcomes, failure rates, and other objective parameters following reconstruction of the ACL. In addition, this review discusses mechanical considerations related to different allograft tissues.

Original languageEnglish
Pages (from-to)249-262
Number of pages14
JournalOrthopedic Clinics of North America
Volume41
Issue number2
DOIs
StatePublished - Apr 2010
Externally publishedYes

Keywords

  • Anterior cruciate ligament
  • Bone-patellar tendon-bone composites
  • Combined semitendinosus and gracilis hamstring tendons
  • Revision

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