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Comparative Study
. 2025 May 20;145(1):303.
doi: 10.1007/s00402-025-05919-4.

Comparison of clinical, radiological, and second-look arthroscopic outcomes between hamstring autograft and tibialis allograft following remnant-tensioning anterior cruciate ligament reconstruction

Sung-Sahn Lee  1 , Young Jin Choi  2 , Juyong Oh  2 , Dong Jin Ryu  3 , Joon Ho Wang  4   5
Affiliations
Comparative Study

Comparison of clinical, radiological, and second-look arthroscopic outcomes between hamstring autograft and tibialis allograft following remnant-tensioning anterior cruciate ligament reconstruction

Sung-Sahn Lee et al. Arch Orthop Trauma Surg. .

Abstract

Background: The remnant-tensioning (RT) anterior cruciate ligament reconstruction (ACLR) has been reported to have excellent postoperative outcomes. However, the influence of graft selection on postoperative outcomes of autografts and allografts after RT-ACLR has been poorly investigated. The purpose of our study was to compare the clinical, radiological, and second-look arthroscopic outcomes of autografts and allografts following RT-ACLR.

Methods: Between January 2013 and May 2020, 94 and 64 patients were enrolled in auto (hamstring tendon) and allo (tibialis tendon) groups, respectively. For subgroup analysis, patients were divided into two age categories: ≤34 and > 34 years of age. Stability tests, including the Lachman and Pivot shift tests, side-to-side differences on Telos stress radiographs and KT-2000 arthrometer, patient-reported outcome measurements (PROMs), and graft status on postoperative magnetic resonance imaging (MRI) and second-look arthroscopy, were evaluated and compared between the two groups.

Results: The two groups showed no statistically significant differences in stability outcomes or PROMs for patients aged ≤ 34 and > 34 years. Furthermore, both groups demonstrated comparable postoperative graft status on postoperative MRI and second-look arthroscopy analyses in patients aged ≤ 34 and > 34 years.

Conclusion: RT-ACLR using allografts yielded similar postoperative clinical outcomes, MRI findings, and second-look results compared to autografts, irrespective of patients' age. Therefore, allografts may serve as a viable option for patients scheduled for RT-ACLR.

Keywords: Allograft; Anterior cruciate ligament; Autograft; Remnant preservation; Remnant tensioning.

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Conflict of interest statement

Declarations. Ethical approval: The protocol used to evaluate data was approved by the institutional review board (SMC2023-11-008). Informed consent: Informed consent was obtained from all participants included in the study. Conflict of interest: J.H.W. received the research grant from Korean Fund funded by Ministry of Science and ICT, and Ministry of Health and Welfare (RS-2024-KD00340610, RS-2024-KD00334810; Republic of Korea). The other authors have no relevant financial or non-financial interests to disclose.

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