Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 26, Issue 4, pp 1281–1287 | Cite as

Hamstring autograft maturation is superior to tibialis allograft following anatomic single-bundle anterior cruciate ligament reconstruction

  • Sang-Gyun Kim
  • Soo-Hyun Kim
  • Jae-Gyoon Kim
  • Ki-Mo Jang
  • Hong-Chul Lim
  • Ji-Hoon Bae



Using second-look arthroscopy, graft maturation was investigated and compared between hamstring (HA) autografts and tibialis anterior (TA) allografts after anatomic single-bundle anterior cruciate ligament reconstruction (ACLR).


Fifty-six patients who underwent second-look arthroscopy after anatomic single-bundle ACLR with either HA autografts (26, HA group) or TA allografts (30, TA group) from 2007 to 2016 were retrospectively reviewed. Graft maturation on second-look arthroscopy was evaluated in terms of four parameters: graft integrity (tear), synovial coverage, graft tension, and graft vascularization. Each parameter received a maximum of two points, depending on the status of the reconstructed graft. The total graft maturation score was calculated as the sum of the parameter scores. The total graft maturation and individual parameter scores were compared between the two groups.


The mean time from ACLR to second-look arthroscopy was 22.5 ± 7.8 months. The maturation scores in the HA group were significantly better in terms of graft integrity (p = 0.041), graft tension (p = 0.010), and graft vascularization (p = 0.024), whereas the graft synovial coverage score was not significantly different. The total graft maturation score of the HA group was significantly higher than that of the TA group (6.3 ± 0.4 vs. 4.9 ± 0.3, p = 0.013).


This study shows the superior graft maturation of HA autografts compared with that of TA allografts at a mean follow-up of 22.5 ± 7.8 months after anatomic single-bundle ACLR. When anatomic ACLR using soft tissue graft is planned, HA autograft is recommended rather than soft tissue allograft, especially in young and active patients.

Level of evidence

Retrospective cohort review, Level III.


Anterior cruciate ligament reconstruction Hamstring Tibialis anterior Second-look surgery Arthroscopy 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest related to this study.


This study was supported by a grant from Korea University.

Ethical approval

This study was approved by the institutional review board of our institution (ID: KUGH16107-003, Korea University Guro Hospital).


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2017

Authors and Affiliations

  1. 1.Department of Orthopaedic Surgery, Korea University Guro HospitalKorea University College of MedicineGuro-gu, SeoulRepublic of Korea
  2. 2.Department of Orthopaedic Surgery, Korea University Ansan HospitalKorea University College of MedicineAnsanRepublic of Korea
  3. 3.Department of Orthopaedic Surgery, Korea University Anam HospitalKorea University College of MedicineSeoulRepublic of Korea
  4. 4.Department of Orthopaedic SurgerySeoul Barunsesang HospitalSeoulRepublic of Korea

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