Evidence map›Paper›PMID 37000243›Full record

SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023

Lower donor site morbidity with hamstring and quadriceps tendon autograft compared with bone-patellar tendon-bone autograft after anterior cruciate ligament reconstruction: a systematic review and network meta-analysis of randomized controlled trials.

Kyle N Kunze, Jay Moran, Evan M Polce, Ayoosh Pareek, Sabrina M Strickland, Riley J Williams

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 3 pooled it
19.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 3 syntheses or guidelines pooled it, 62 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Quadriceps versus hamstrings autograft in anterior cruciate ligament reconstruction: a randomized control trial.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
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  9. Pediatric ACL Injuries: A Current Concepts Review.Journal of clinical medicine · 2026
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  20. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Kyle N KunzeDepartment of Orthopaedic Surgery, Hospital for Special Surgery, East 70th Street, New York, NY, 53510021, USA. kylekunze7@gmail.com.ORCID http://orcid.org/0000-0002-0363-3482
Jay MoranYale School of Medicine, New Haven, CT, USA.
Evan M PolceSchool of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Ayoosh PareekDepartment of Orthopaedic Surgery, Hospital for Special Surgery, East 70th Street, New York, NY, 53510021, USA.
Sabrina M StricklandDepartment of Orthopaedic Surgery, Hospital for Special Surgery, East 70th Street, New York, NY, 53510021, USA.
Riley J WilliamsDepartment of Orthopaedic Surgery, Hospital for Special Surgery, East 70th Street, New York, NY, 53510021, USA.
Hospital for Special Surgery · USUniversity of Wisconsin–Madison · USYale University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo perform a meta-analysis of RCTs evaluating donor site morbidity after bone-patellar tendon-bone (BTB), hamstring tendon (HT) and quadriceps tendon (QT) autograft harvest for anterior cruciate ligament reconstruction (ACLR).

methodsPubMed, OVID/Medline and Cochrane databases were queried in July 2022. All level one articles reporting the frequency of specific donor-site morbidity were included. Frequentist model network meta-analyses with P-scores were conducted to compare the prevalence of donor-site morbidity, complications, all-cause reoperations and revision ACLR among the three treatment groups.

resultsTwenty-one RCTs comprising the outcomes of 1726 patients were included. The overall pooled rate of donor-site morbidity (defined as anterior knee pain, difficulty/impossibility kneeling, or combination) was 47.3% (range, 3.8-86.7%). A 69% (95% confidence interval [95% CI]: 0.18-0.56) and 88% (95% CI: 0.04-0.33) lower odds of incurring donor-site morbidity was observed with HT and QT autografts, respectively (p < 0.0001, both), when compared to BTB autograft. QT autograft was associated with a non-statistically significant reduction in donor-site morbidity compared with HT autograft (OR: 0.37, 95% CI: 0.14-1.03, n.s.). Treatment rankings (ordered from best-to-worst autograft choice with respect to donor-site morbidity) were as follows: (1) QT (P-score = 0.99), (2) HT (P-score = 0.51) and (3) BTB (P-score = 0.00). No statistically significant associations were observed between autograft and complications (n.s.), reoperations (n.s.) or revision ACLR (n.s.).

conclusionACLR using HT and QT autograft tissue was associated with a significant reduction in donor-site morbidity compared to BTB autograft. Autograft selection was not associated with complications, all-cause reoperations, or revision ACLR. Based on the current data, there is sufficient evidence to recommend that autograft selection should be personalized through considering differential rates of donor-site morbidity in the context of patient expectations and activity level without concern for a clinically important change in the rate of adverse events. LEVEL OF EVIDENCE: Level I.

Indexed as

Anterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionHamstring TendonsPatellar LigamentAutograftsBone-Patellar Tendon-Bone GraftingHumansMorbidityRandomized Controlled Trials as TopicTendonsTransplantation, AutologousACLAnterior cruciate ligamentAutograftDonor siteMeta-analysisMorbidityNetworkReconstruction

Identifiers

PMID37000243
OpenAlexW4362458985

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.