A Matched-pair Comparison of Patient-reported Outcomes following Primary ACL Reconstruction with Hamstring Autograft vs Hybrid Graft

Abstract

estimated area of physeal disruption (1.64 cm2 vs. 0.74 cm2, P<0.001), femoral (32.1 vs. 72.8 , P<0.001) and tibial (50.1 vs. 60.5 , P¼0.003) tunnel drill angles, medial/lateral location of the femoral tunnel (24.2 mm vs. 36.1 mm from lateral cortex, P¼0.001), and distance from the lateral aspect of the distal femoral physis and the femoral tunnel exit (4.7mm vs. 26.7mm from the perichondrial ring, P<0.001). All patients who underwent femoral tunnel drilling at an angle of greater than 25 from the transverse axis experienced a <6% disruption of physeal area. Conclusion: With femoral tunnel drilling techniques that create more oblique tunnels, the area of physeal damage is larger, more eccentric and closer to the perichondrial ring. Since most studies noting the safety of transphyseal ACL reconstruction have utilized a vertical femoral tunnel, surgeons should be aware that if an independent femoral tunnel drilling technique is utilized during transphyseal ACL reconstruction, the physis is at greater risk when drilling at more horizontal angles. Angles greater than 25 from the transverse axis may safely create <6% physeal area damage.

<p>Hybrid graft vs autograft in anterior cruciate ligament reconstruction: a meta-analysis</p>

“…After titles and abstracts had been scanned, 116 reports were excluded according to the eligibility criteria. Kraeutler et al conducted two studies – in 2016 9 and 2018 10 – that both matched eligibility criteria with overlapped data. As such, the later study was included for further data pooling and analysis, because of the larger patient sample.…”