Return to Sport After ACL Reconstruction: Hamstring Tendons vs Patellar Tendon A Systematic Review and Meta-analysis

Anterior cruciate ligament (ACL) rupture in young athletes is a common and devastating injury. The gold standard for treatment in young athlete population remains reconstruction using autografts especially bone-patellar tendon-bone (BTB) graft and hamstring tendons (HT) graft. A systematic review was conducted to compare the rates of overall return to sport (RTS), return to preinjury levels, and re-ruptures between young athletes who have undergone primary ACL reconstruction using a BTB versus HT autograft. 30 studies were included in the final analysis. A total of 5871 patient-athletes who underwent ACL reconstruction were included. Among them, 1684 patients received BTB and 4187 patients received HT. The overall RTS rate was 73.8%. The overall re-rupture rate was 4.2%. Higher rates of RTS and return to preinjury level, as well as a lower re-rupture rate, were observed in the BTB autograft. However, these differences did not reach statistical significance.