Randomized Trialhigh evidence
Fourfold higher graft failure risk with isolated BPTB versus hamstring ACL reconstruction with ALL in patients under 25 years: A prespecified subgroup analysis of a randomized controlled trial.
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA·September 21, 2026·PMID 42766437
Why it mattersYoung patients have the highest risk of ACL graft failure, and graft choice plus lateral extra-articular augmentation may substantially affect durability. This trial provides high-level evidence that combining hamstring ACLR with ALLR reduces graft failure compared with isolated BPTB in this high-risk population, informing surgical decision-making for orthopedic surgeons.
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