title: Anterior Cruciate Ligament Reconstruction Using a Combination of Autograft and Allograft Tendon: A MOON Cohort Study.
abstract: BACKGROUND
  Anterior cruciate ligament (ACL) reconstruction with hamstring autografts less than 8.5 mm in diameter is associated with worse patient-reported outcome scores and increased risk of revision surgery compared with reconstructions performed with larger grafts. One proposed solution to small autograft harvest is to create a hybrid graft by augmenting autografts with allograft tissue to increase graft diameter.
  
  
  OBJECTIVE
  To compare hybrid autograft/allograft ACL reconstruction to autograft ACL reconstruction, specifically analyzing the patient-reported outcome scores and the risk of revision surgery at 2 years postoperative.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  From the years 2002 to 2009, a total of 34 patients were identified from a prospectively collected database as having undergone hybrid ACL reconstruction. Twenty-seven of 34 (79.4%) patients had a 2-year follow-up. These 27 patients were matched by age (within 1 year) and sex to 27 patients who underwent hamstring autograft ACL reconstruction during the same period. At the 2-year mark, revision surgery risk and patient-reported outcome scores were compared between the 2 groups.
  
  
  RESULTS
  The mean age for the hybrid and matched groups (±SD) was 20.9 ± 7.0 years. Both the hybrid and control groups had 17 males and 10 females. There was no significant difference in preoperative patient-reported outcome scores, meniscus tears, or cartilage lesions between the 2 groups. Graft size was larger in the hybrid group (9.5 ± 0.6 mm) than in the autograft group (8.4 ± 0.9 mm) (P < .001). At 2 years postoperative, patient-reported outcome scores were similar between the hybrid and autograft groups. Revision surgery was required in 5 (18.5%) patients who underwent hybrid reconstruction compared with 2 (7.4%) of those who underwent autograft reconstruction (P = .26).
  
  
  CONCLUSIONS
  Patients who undergo ACL reconstruction with hybrid hamstring grafts and hamstring autografts report similar patient-reported outcome scores at 2 years postoperative but may be at increased risk for revision ACL reconstruction.
authors: OSU Sports Medicine, Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio, USA.
authors: James E
authors: JE
authors: Darnley
authors: OSU Sports Medicine, Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio, USA.; Department of Orthopaedics, The Ohio State University, Columbus, Ohio, USA.
authors: Benjamin
authors: B
authors: Léger-St-Jean
authors: OSU Sports Medicine, Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio, USA.
authors: Angela D
authors: AD
authors: Pedroza
authors: OSU Sports Medicine, Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio, USA.; Department of Orthopaedics, The Ohio State University, Columbus, Ohio, USA.
authors: David C
authors: DC
authors: Flanigan
authors: OSU Sports Medicine, Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio, USA.; Department of Orthopaedics, The Ohio State University, Columbus, Ohio, USA.
authors: Christopher C
authors: CC
authors: Kaeding
authors: OSU Sports Medicine, Sports Health and Performance Institute, The Ohio State University, Columbus, Ohio, USA.; Department of Orthopaedics, The Ohio State University, Columbus, Ohio, USA.
authors: Robert A
authors: RA
authors: Magnussen
keywords: ACL reconstruction; allograft; hybrid graft; outcomes