Abstract
To compare (1) patient-reported outcomes, (2) objective knee measures of stability, (3) failures, and (4) reoperations after primary anterior cruciate ligament (ACL) reconstruction with semitendinosus-gracilis autograft versus autograft-allograft hybrid grafts. We performed a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Multiple databases were searched for studies that compared outcomes of ACL reconstruction with semitendinosus-gracilis autograft versus autograft-allograft hybrid grafts in adult human patients with minimum 2-year follow-up. Knee-specific patient-reported outcome scores, objective knee measures of stability, failures, and reoperations were reported for each study and compared between semitendinosus-gracilis autografts and hybrid grafts. Study heterogeneity and levels of evidence precluded meta-analysis. We analyzed 6 articles (544 patients; 54.5% male patients; mean age, 30.9 ± 3.9years; mean follow-up period, 43.6±15.5months). Of 6 studies, 4 showed no significant differences in International Knee Documentation Committee and Lysholm scores between the semitendinosus-gracilis autograft and hybrid groups. Five of six studies showed no significant differences in KT-1000 measurements between groups. The risk of ACL failure ranged from 3.2% to 8.4% for semitendinosus-gracilis autografts and from 2.4% to 14.3% for hybrid grafts, with no study reporting a significant difference in failure rates between groups. The reoperation rate in the subjects undergoing ACL reconstruction with semitendinosus-gracilis autografts and hybrid grafts ranged from 2.8% to 10.3% and from 2.4% to 48.3%, respectively. In 5 of 6 studies, no significant differences in reoperation rates were found between groups. Most studies reported no significant differences in patient-reported outcome scores, objective knee measures of stability, and reoperation rates between semitendinosus-gracilis autografts and hybrid grafts. No significant difference in ACL failure rates was found between groups in any study. Level III, systematic review of Level II and III studies.
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