Improved ACL reconstruction outcome using double-layer BPTB allograft compared to that using four-strand hamstring tendon allograft

Abstract Background This study compared the clinical outcomes of anterior cruciate ligament reconstruction using double-layer bone–patellar tendon–bone (DBPTB) allografts and four-strand hamstring (4SHS) grafts. Methods This prospective randomized controlled trial included 101 patients. Of these, 50 patients received DBPTB allografts, and 51 received 4SHS grafts. Evaluations included KT-1000 arthrometer measurements, Lachman tests, pivot-shift tests, the International Knee Documentation Committee (IKDC) classification and Lysholm scores at three year postoperative follow-up. Results Two DBPTB patients (four percent) and nine 4SHS patients (17.6%) had graft failures, which was significantly different ( P =0.028). The DBPTB group had significantly better Lachman test, IKDC knee score and Lysholm score results than the 4SHS group ( P Conclusions DBPTB allografts had fewer graft failures at three years than 4SHS grafts for anterior cruciate ligament reconstruction; and there were statistically significant differences but not clinically significant differences between DBPTB and 4SHS grafts in terms of the KT1000 test, IKDC and Lysholm scores.