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May 3, 2026

Isolated hamstring tendon autograft should be avoided in high-risk patients undergoing anterior cruciate ligament reconstruction : a New Zealand ACL Registry study.

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Authors

RRRichard RahardjaHLHamish LoveMCMark Clatworthy

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Overview

Randomized trial compares revision rates of graft types in high-risk patients, suggesting BTB may be preferable.

Key Points

  • This study aims to evaluate the revision rates of hamstring tendon autografts versus BTB grafts in high-risk patients undergoing ACL reconstruction.
  • Analyzed prospective data from the New Zealand ACL Registry for primary reconstructions between April 2014 and March 2022.
  • Included high-risk patients aged 14-25 years with specific criteria related to ACL injury and pre-injury activity level.
  • Used chi-squared test and Cox regression survival analysis to compare revision rates.
  • Hamstring autograft had a revision rate of 11.4% versus 4.3% for the BTB autograft (p < 0.001).
  • Hamstring tendon autograft had a 2.5 times higher risk of revision compared to BTB (adjusted HR 2.5, 95% CI 1.9 to 3.3; p < 0.001).
  • Number needed to treat with BTB to prevent one revision was 14 patients.

Cite This Study

Rahardja et al. (2026) studied this question.

synapsesocial.com/papers/69f6e6648071d4f1bdfc7185https://doi.org/10.1302/0301-620x.108b5.bjj-2025-0181.r4
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