Allograft Augmentation of Hamstring Autograft in Anterior Cruciate Ligament Reconstruction Results in Equivalent Outcomes to Autograft Alone

Allison J. Rao, David M. Macknet, Casey R. Stuhlman, Nicholas C. Yeatts, David P. Trofa, Susan M. Odum, Bryan M. Saltzman, James E. Fleischli

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Purpose: To examine allograft augmentation of undersized hamstring (HS) autograft tendons at the time of anterior cruciate ligament (ACL) reconstruction, compared with un-augmented autograft HS ACL reconstruction. Methods: Patients who underwent ACL reconstruction at our institution between 2005 and 2015 were reviewed. Inclusion criteria included patients who underwent (1) primary ACL reconstruction, (2) use of a hybrid HS autograft with allograft augmentation, and (3) had a minimum 2-year postoperative follow-up. Patients with revision ACL, multiligamentous injuries, all-epiphyseal fixation techniques, or additional procedures beyond chondroplasty or meniscal repair/debridement were excluded. Data collected included demographics, graft size, concomitant procedures, revision operation, revision ACL reconstruction, and patient-reported outcomes. Results: In total, 59 patients met criteria for inclusion into the hybrid group, and 80 patients were eligible for inclusion into the control group. The average age of the cohort was 22.9 (interquartile range Q1:17, Q3: 38.3), and 51.8% of the patients were female. Seven patients (11.9%) in the hybrid ACL group underwent revision ACL surgery versus 15 (18.8%) in the control group (P =.27). There was no difference in patient-reported outcomes between groups. Conclusions: Augmenting an HS ACL autograft that is 8 mm or less with allograft tissue to increase the overall size of the ACL graft shows no difference in overall reoperation or revision of ACL failure. The hybrid autograft/allograft ACL reconstruction patients showed no clinically important difference between groups in patient-reported outcome measures. Level of Evidence: Level III, case–control comparative analysis.

Original languageEnglish (US)
Pages (from-to)173-182.e2
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Issue number1
StatePublished - Jan 2021
Externally publishedYes

Bibliographical note

Funding Information:
The authors report the following potential conflicts of interest or sources of funding: S.M.O. reports personal fees from the American Joint Registry, other from Lumbar Spine Research Society, and other from North American Spine Society, outside the submitted work. B.M.S. reports personal fees and other from Nova Science Publishers, outside the submitted work. J.E.F. reports other from Arthrex and Smith & Nephew, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.

Publisher Copyright:
© 2020 Arthroscopy Association of North America


Dive into the research topics of 'Allograft Augmentation of Hamstring Autograft in Anterior Cruciate Ligament Reconstruction Results in Equivalent Outcomes to Autograft Alone'. Together they form a unique fingerprint.

Cite this