Randomized controlled trial comparing clinical and functional outcomes of bone-patellar tendon-bone and hamstring tendon autografts in ACL reconstruction

Objectives: The purpose of this randomized trial was to compare the clinical and functional outcomes of anterior cruciate ligament reconstruction (ACLR) using hamstring tendon (HT) and bone-patellar tendon-bone (BTB) autografts. Materials and Methods: Thirty-eight patients with isolated ACL injuries were randomized to undergo ACLR using either HT ( n = 19) or BTB ( n = 19) autografts. All procedures were performed using an anatomic single-bundle arthroscopic technique. Patients were evaluated preoperatively and at 12 months postoperatively using the International Knee Documentation Committee (IKDC) score, rolimeter testing, Lachman and pivot-shift tests, single-leg hop test, and range of motion. Results: Both groups demonstrated significant post-operative improvement across all parameters. The mean IKDC score was 82.6 ± 6.3 in the HT group and 83.2 ± 5.9 in the BTB group. No significant differences were observed between groups in terms of knee stability, hop test performance, or return-to-sport rates. No complications or graft failures occurred during follow-up. Conclusion: ACLR using either HT or BTB autografts provided comparable clinical and functional outcomes at 1-year follow-up. Graft choice should be individualized based on patient characteristics and surgeon preference.