What is the optimal graft for anterior cruciate ligament reconstruction? A scoping review

Abstract

Abstract Background: Bone-patellar tendon-bone and hamstring autografts are the most commonly utilized autografts for anterior cruciate ligament reconstruction. However, although comprehensive studies have compared both grafts, the optimal graft is still debatable. Question/Purpose: To demonstrate the optimal graft used by comparing HS and BPTB grafts based on the PROMs. Method: The Relevant articles were identified after using the research question to search the electronic database Pubmed. Patients >18 years of age of both genders were included in the study. The patients underwent anterior cruciate ligament reconstruction (ACLR) with bone-patella tendon-bone and hamstring autografts. Result: A total of 5,997 patients enrolled in the study (5,665 male, 332 female) were divided into two groups. No significant differences were found between bone-patella tendon-bone and hamstring autografts according to the patient-reported outcome measures (PROMs), and both grafts revealed improvement at the 1-2-year follow-up period. However, bone-patella tendon-bone grafts show a better result in most PROMs. Conclusion: Both grafts have advantages and disadvantages. Bone-patella tendon-bone grafts resulted in a high risk of anterior knee pain, while hamstring grafts resulted in a high risk of knee laxity. Level of evidence: Scoping review Keywords: anterior cruciate ligament, ACL reconstruction, hamstring graft, patella graft.