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Francisco Figueroa Knee Unit, Hospital Dr Sotero del Rio, Chile; Knee Unit, Clinica Alemana-Universidad del Desarrollo, Chile

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David Figueroa Knee Unit, Clinica Alemana-Universidad del Desarrollo, Chile

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João Espregueira-Mendes Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Portugal; Dom Henrique Research Centre, Portugal; 3B’s Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Portugal; ICVS/3B’s–PT Government Associate Laboratory, Portugal; Orthopaedics Department of Minho University, Portugal

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or desire for future participation in cutting or pivoting sports. There are multiple graft options for ACL reconstruction including bone-patellar tendon-bone (BPTB) autograft, quadriceps tendon autograft, hamstring tendon autograft and several

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Nikolaos K. Paschos University of California, Davis, USA

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Stephen M. Howell University of California, Davis, USA

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of contention. 28 Also, allograft versus autograft has also been a topic of controversy. Regarding the intervention type, the description of the double-bundle technique created expectations for a more anatomical technique, but there is dispute

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Francisco Figueroa Clinica Alemana-Universidad del Desarrollo, Santiago, Chile
Hospital Sotero del Rio, Santiago, Chile

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David Figueroa Clinica Alemana-Universidad del Desarrollo, Santiago, Chile

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Rafael Calvo Clinica Alemana-Universidad del Desarrollo, Santiago, Chile

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Alex Vaisman Clinica Alemana-Universidad del Desarrollo, Santiago, Chile
Hospital Padre Hurtado, Santiago, Chile

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João Espregueira-Mendes Clínica do Dragão, Espregueira-Mendes Sports Centre – FIFA Medical Centre of Excellence, Portugal; Dom Henrique Research Centre, Portugal; 3B’s Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Portugal; ICVS/3B’s–PT Government Associate Laboratory, Portugal; Orthopaedics Department of Minho University, Portugal

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treatment, there is an increased risk of articular cartilage damage and graft failure and a long-term risk of joint dysfunction. 3 – 6 Hamstring autograft use has been linked to an increased risk of infection after ACL reconstruction compared to other

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Joanna Baawa-Ameyaw Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK

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Ricci Plastow Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK

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Fahima Aarah Begum Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK

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Babar Kayani Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK

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Hyder Jeddy Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK

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Fares Haddad Department of Trauma and Orthopaedic Surgery, University College Hospital, London, UK
Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK

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commonly used grafts for ACLR include hamstring tendon (HT), bone–patellar tendon–bone (BPTB) and quadriceps tendon (QT) autografts, allografts and synthetic grafts. However, there is no uniform consensus on the single best graft choice for ACLR, with

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Francisco Figueroa Hospital Sótero del Río, Santiago, Chile
Clínica Alemana-Universidad del Desarrollo, Santiago, Chile

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David Figueroa Hospital Sótero del Río, Santiago, Chile

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Rafael Calvo Hospital Sótero del Río, Santiago, Chile

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Alex Vaisman Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
Hospital Padre Hurtado, Santiago, Chile

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João Espregueira-Mendes Clínica do Dragão, Espregueira-Mendes Sports Centre – FIFA Medical Centre of Excellence, Porto, Portugal
Dom Henrique Research Centre, Portugal
3Bs Research Group – Biomaterials, Biodegradables and Biomimetics, University of Minho, Braga, Portugal
ICVS/3Bs–PT Government Associate Laboratory, Braga, Portugal
Orthopaedics Department of Minho University, Braga, Portugal

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condition of the autograft tissues and the attempt to limit further damage to the patient by harvesting autografts. They suggest that such practical issues may in fact outweigh clinical evidence. Tisherman et al, 11 in another review of the literature

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Mukai Chimutengwende-Gordon Joint Reconstruction Unit, Royal National Orthopaedic Hospital Trust, Stanmore, UK

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James Donaldson Joint Reconstruction Unit, Royal National Orthopaedic Hospital Trust, Stanmore, UK

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George Bentley Joint Reconstruction Unit, Royal National Orthopaedic Hospital Trust, Stanmore, UK

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Mosaicplasty or osteochondral autograft transfer Mosaicplasty or the osteochondral autograft transfer system (OATS) results in immediate filling of osteochondral defects with hyaline cartilage. 13 The procedure involves harvesting multiple cylindrical

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E. Carlos Rodríguez-Merchán Department of Orthopedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain
Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research – IdiPAZ (La Paz University Hospital – Autonomous University of Madrid), Madrid, Spain

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Hortensia De la Corte-Rodríguez Department of Physical and Rehabilitation Medicine, La Paz University Hospital, Madrid, Spain

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Carlos A. Encinas-Ullán Department of Orthopedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain

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Primitivo Gómez-Cardero Department of Orthopedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain

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used in MLKI reconstructions is another controversial issue. There are currently three options: autografts, allografts, or synthetic grafts, although we think that it is better to use a fresh frozen non-irradiated allograft. Each of these options has

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Mattia Alessio-Mazzola IRCCS Ospedale San Raffaele, Unità Clinica di Ortopedia e Traumatologia, Via Olgettina, Milan, Italy

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Giacomo Placella Università Vita-Salute San Raffaele, Via Olgettina, Milan, Italy

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Luigi Zagra Hip Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

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Orlando Leone Università Vita-Salute San Raffaele, Via Olgettina, Milan, Italy

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Natasha Di Fabio Università Vita-Salute San Raffaele, Via Olgettina, Milan, Italy

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Desiree Moharamzadeh IRCCS Ospedale San Raffaele, Unità Clinica di Ortopedia e Traumatologia, Via Olgettina, Milan, Italy

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Vincenzo Salini Università Vita-Salute San Raffaele, Via Olgettina, Milan, Italy

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) NR BPTB autograft  7 34 all components cemented; 1 component uncemented; 1 cemented femoral component; uncemented tibial component; patella resurfaced in all cases 24 cruciate sacrificing (posterior stabilized); 9 cruciate retaining; 3

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Jimmy Wui Guan Ng Chesterfield Royal Hospital NHS Foundation Trust, Calow, Chesterfield, UK

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Yulanda Myint Chesterfield Royal Hospital NHS Foundation Trust, Calow, Chesterfield, UK

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Fazal M. Ali Chesterfield Royal Hospital NHS Foundation Trust, Calow, Chesterfield, UK

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%) Note . NR, not reported; SMD, standardised mean difference. Graft choice Graft selection can be challenging in multiligament knee reconstruction. Surgeons have the option of using autograft, allograft or synthetic graft. Each of these

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Carlos A. Encinas-Ullán Department of Orthopaedic Surgery, ‘La Paz’ University Hospital-IdiPaz, Spain

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E. Carlos Rodríguez-Merchán Department of Orthopaedic Surgery, ‘La Paz’ University Hospital-IdiPaz, Spain

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-bundle anatomical (isolated sMCL reconstructions) Preserving the insertion of a semitendinosus autograft for augmentation repair for the sMCL has limitations. The graft does not reconstruct the course of the native MCL ligament (too anterior on the tibia). Grafts

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