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. 2023 May 27;5(3):e725-e730.
doi: 10.1016/j.asmr.2023.03.015. eCollection 2023 Jun.

Autograft-Only and Allograft-Augmented Hamstring Autograft Have Similar Failure Rates After Anterior Cruciate Ligament Reconstruction

Bryan G Adams  1 , Matthew J Nowak  2 , Alec C Egan  2 , Michael A Donohue  1 , Joseph W Galvin  2 , Edward D Arrington  3
Affiliations

Autograft-Only and Allograft-Augmented Hamstring Autograft Have Similar Failure Rates After Anterior Cruciate Ligament Reconstruction

Bryan G Adams et al. Arthrosc Sports Med Rehabil. .

Abstract

Purpose: To compare failure rates and clinical outcomes after hamstring autograft anterior cruciate ligament (ACL) reconstruction with and without allograft augmentation by a single surgeon otherwise using the same surgical technique.

Methods: This was a retrospective analysis with prospectively collected patient-reported outcomes of primary hamstring autograft ACL reconstruction with and without allograft augmentation performed in a military population by a single surgeon. The primary outcome measure was graft failure, defined as graft rupture confirmed by use of magnetic resonance imaging scans and/or revision ACL reconstruction. The secondary outcome measure was the postoperative Knee Injury and Osteoarthritis Outcome Score.

Results: This study included 112 patients with a mean follow-up period of 65.3 months. In patients with a graft diameter of 8 mm or greater, there was no difference in failure rates (9.4% for autograft only vs 6.3% for hybrid, P = .59). There was a higher failure rate in patients in the autograft-only group with a graft diameter of less than 8 mm (29.4%) when compared with the hybrid graft group (6.3%, P = .008). There were no hybrid grafts less than 8 mm in diameter. There were no differences in the Knee Injury and Osteoarthritis Outcome Score between groups as long as the graft diameter was 8 mm or greater.

Conclusions: In patients undergoing hamstring ACL reconstruction, there was no significant difference in graft failure rates or outcome scores between autograft only and autograft with allograft augmentation as long as grafts were 8 mm or greater. High failure rates were seen when the graft diameter was less than 8 mm.

Level of evidence: Level III, retrospective cohort study.

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Figures

Fig 2
Fig 2
Sizing of hamstring autograft augmented with allograft.
Fig 1
Fig 1
CONSORT (Consolidated Standards of Reporting Trials) diagram.
See this image and copyright information in PMC

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