A 22-year-old basketballer sustains a non-contact injury to the knee landing from a jump. He hears a 'pop' and the knee swells rapidly within 2 hours (hemarthrosis). MRI confirms complete ACL rupture. In ACL reconstruction, the gold standard graft choice for primary reconstruction in athletes is:
- A Synthetic ligament (LARS)
- B Iliotibial band autograft
- C Fresh frozen allograft
- D Bone-patellar tendon-bone (BPTB) autograft ✓
Explanation
The bone-patellar tendon-bone (BPTB) autograft (central third of patellar tendon with bone plugs) remains the gold standard for ACL reconstruction in competitive athletes — it provides highest initial graft strength, bone-to-bone healing at the tunnel apertures (faster and stronger integration), and excellent long-term stability. Hamstring tendon (semitendinosus-gracilis double bundle) is an alternative with reduced donor site morbidity. Allograft is suitable in older, lower-demand patients or revision surgery, but carries higher failure rates in young athletes. Synthetic grafts (LARS) have potential synovitis and implant failure concerns and are not the gold standard.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.