Clinical Outcomes and Failure Rate of Anterior Cruciate Ligament Reconstruction Using Autograft Hamstring Versus a Hybrid-graft

Journey around the Notch: A Systematic Review on the History of ACL Reconstruction in the United States

“…technique was used in three of 27 studies (two of these studies used the single-incision, transtibial technique in addition to the two-incision technique in their patients). 60,64,76 After 2010, two of four papers described a single-incision with anteromedial portal approach, 80,81 and one of four papers described a transportal retrograde drilling technique, or an "all inside" technique. 83 These results are summarized in ►Table 3, and further information on tunnel location is described in ►Table 4.…”

“…18 In the 2000 to 2009 group of studies, three studies performed double-bundle reconstructions, 65,71,74 one study performed a primary ACL repair, 78 and the rest performed single-bundle reconstructions. [53][54][55][56][57][58][59][60][61][62][63][64][66][67][68][69][70][71][72][73][75][76][77]79 The four studies after 2010 all performed single-bundle ACL reconstructions, [80][81][82][83] with Murray et al additionally performing their bridge-enhanced native tissue ACL repair. 82…”

“…26,27,33,36,44,[49][50][51] From 2000 to 2009, 17 of 27 studies used a hamstring autograft, 53-55,57-59,61,63-65,67,68,72,74-76, 79 10 of 27 studies used a BPTB autograft, 53,[55][56][57]60,64,[66][67][68]77 six of 27 studies reconstructed with a BPTB allograft, 56,57,62,64,66,77 and five of 27 studies used a tibialis anterior allograft. [63][64][65]71,74 After 2010, hamstring autograft was used in three of them, 80,82,83 tibialis anterior allograft was used in one of them, 81 and a hybrid hamstring autograft with tibialis anterior allograft was also used in one of the hamstring autograft studies. 80 A full summary of ACL graft choice, stranding, and fixation can be found in ►Tables 5-6.…”

“…75,76,79 None of the 27 studies attempted extra-articular procedures. After 2010, two of four studies performed graft augmentation-one with a tibialis allograft, 80 and the other with an extracellular matrix scaffold to augment a repair of the native ACL fibers. 82 (►Table 7)…”

Editorial Commentary: The Jury Remains Out on Hybrid Autograft-Plus-Allograft for Diminutive Hamstring Anterior Cruciate Ligament Autografts

“…5 Despite preoperative surgical planning, a small diameter quadrupled hamstring autograft may still be encountered intraoperatively because of iatrogenic graft damage during harvest or human variability of hamstring size. In their study, Leo et al 7 encountered a diminutive graft, which they defined as less than 8 mm, 25% of the time (24 of 95). There are several options as to reconciling this situation intraoperatively, including (1) abandoning the diminutive graft and using an all allograft concept, (2) using the autograft available and augmenting this with an allograft, or (3) using a 5-or 6strand construct if the semitendinosus is of appropriate size.…”