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

Abstract

With the relatively recent introduction of hybrid autograft-allograft grafts for anterior cruciate ligament reconstruction (ACLR), few studies have compared outcomes between autografts versus hybrid grafts. The purpose of this study is to compare patient-rated outcomes between hamstring autografts and hybrid grafts for ACLR. At a minimum two-year follow-up, patients who had undergone primary ACLR with hamstring autograft (A) or hybrid (H) graft (hamstring autograft with peroneus longus or tibialis posterior allograft) were contacted to fill out a survey containing the Knee injury and Osteoarthritis Outcome Score (KOOS), Subjective IKDC score, Single Assessment Numeric Evaluation (SANE), SF-12, and visual analog scale (VAS) for activity level prior to injury and at follow-up. A matched-pair analysis was performed by matching patients in each group by gender and by age at the time of surgery within three years. Paired t-tests were used to compare outcomes between groups. Twenty matched-pairs were formed, including nine males and eleven females in each group. Average age at surgery was 34 years (range, 13-57 years). Average follow-up was 3.3 years. No significant differences were found in any of the KOOS subscale scores, Subjective IKDC (A: 75, H: 77), SANE (A: 86, H: 90), SF-12 Physical (A: 53, H: 53) or Mental (A: 53, H: 52) component scores, or activity level prior to injury (A: 7.5, H: 7.4) or at time of follow-up (A: 6.7, H: 6.2). Patients undergoing primary ACL reconstruction with a hybrid graft (hamstring autograft plus allograft) have similar subjective outcomes to those with a hamstring autograft. Further studies are needed to determine patient characteristics which favor the use of hybrid grafts.