Comparison of clinical, radiological, and second-look arthroscopic outcomes between hamstring autograft and tibialis allograft following remnant-tensioning anterior cruciate ligament reconstruction

Background The remnant-tensioning (RT) anterior cruciate ligament reconstruction (ACLR) has been reported to have excellent postoperative outcomes. However, the influence of graft selection on postoperative outcomes of autografts and allografts after RT-ACLR has been poorly investigated. The purpose of our study was to compare the clinical, radiological, and second-look arthroscopic outcomes of autografts and allografts following RT-ACLR. Methods Between January 2013 and May 2020, 94 and 64 patients were enrolled in auto (hamstring tendon) and allo (tibialis tendon) groups, respectively. For subgroup analysis, patients were divided into two age categories: <= 34 and > 34 years of age. Stability tests, including the Lachman and Pivot shift tests, side-to-side differences on Telos stress radiographs and KT-2000 arthrometer, patient-reported outcome measurements (PROMs), and graft status on postoperative magnetic resonance imaging (MRI) and second-look arthroscopy, were evaluated and compared between the two groups. Results The two groups showed no statistically significant differences in stability outcomes or PROMs for patients aged <= 34 and > 34 years. Furthermore, both groups demonstrated comparable postoperative graft status on postoperative MRI and second-look arthroscopy analyses in patients aged <= 34 and > 34 years. Conclusion RT-ACLR using allografts yielded similar postoperative clinical outcomes, MRI findings, and second-look results compared to autografts, irrespective of patients' age. Therefore, allografts may serve as a viable option for patients scheduled for RT-ACLR.