Improved ACL reconstruction outcome using double-layer BPTB allograft compared to that using four-strand hamstring...

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomaterials science

Background:

• Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure.
• Graft choice impacts clinical outcomes.
• This study compares double-layer bone-patellar tendon-bone (DBPTB) allografts and four-strand hamstring (4SHS) grafts.

Purpose of the Study:

• To compare the clinical outcomes of ACL reconstruction using DBPTB allografts versus 4SHS grafts.
• To evaluate graft failure rates and functional knee scores at three-year follow-up.

Main Methods:

• Prospective randomized controlled trial with 101 patients.
• 50 patients received DBPTB allografts, 51 received 4SHS grafts.
• Evaluations included KT-1000 arthrometer, Lachman, pivot-shift tests, IKDC, and Lysholm scores.

Main Results:

• Graft failure occurred in 4% of DBPTB patients versus 17.6% of 4SHS patients (P=0.028).
• DBPTB group showed significantly better Lachman test, IKDC, and Lysholm scores (P<0.05).
• Observed differences in functional scores were not clinically significant.

Conclusions:

• DBPTB allografts demonstrate a statistically significant lower graft failure rate compared to 4SHS grafts for ACL reconstruction at three years.
• While statistically significant, the differences in KT1000, IKDC, and Lysholm scores between DBPTB and 4SHS grafts were not clinically significant.