A 25-year-old sportsman injures his knee during football. Examination reveals a positive anterior drawer test, positive Lachman test, and positive pivot shift test. MRI confirms complete anterior cruciate ligament (ACL) rupture. The ACL graft of choice for reconstruction in a young active athlete is:
- A Synthetic LARS graft
- B Allograft Achilles tendon
- C Bone-patellar tendon-bone (BPTB) or hamstring (semitendinosus-gracilis) autograft ✓
- D Iliotibial band (MacIntosh) reconstruction
Correct answer: C. Bone-patellar tendon-bone (BPTB) or hamstring (semitendinosus-gracilis) autograft
Explanation
Bone-patellar tendon-bone autograft and hamstring tendon autograft are the two gold-standard choices for ACL reconstruction in young active patients. BPTB ('gold standard') provides excellent bone-to-bone healing and high tensile strength, though it carries donor site morbidity (anterior knee pain, kneeling pain). Hamstring graft has less donor site morbidity but relies on tendon-to-bone healing (slower — 12 weeks vs 6 weeks). Allografts carry higher re-tear rates in young patients. Synthetic grafts are not standard of care due to long-term fatigue failure.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.