Graft Choice for Anterior Cruciate Ligament Reconstruction: Superior Tendon-to-Bone Incorporation With Soft-tissue Autograft Compared With Allograft and Hybrid Graft in a Rat Model.

This article focuses on comparing autograft, allograft, and hybrid grafts for anterior cruciate ligament reconstruction (ACLR) using a rat model to evaluate tendon-to-bone healing, biomechanical performance, and functional recovery. The study found that autografts demonstrated superior histological integration, enhanced vascularization, greater new bone formation, and improved biomechanical strength and gait function compared with allografts and hybrid grafts. Allografts and hybrid grafts showed delayed remodeling, increased inflammation, necrosis, and inferior mechanical properties, with hybrid grafts performing intermediate between autografts and allografts. These preclinical findings support the clinical preference for autografts in ACLR and suggest caution when considering allograft or hybrid grafts, highlighting the need for further human studies to validate these results.