A 22-year-old footballer sustains an ACL tear confirmed on MRI. Lachman's test is positive. The ACL graft choice for reconstruction that has the LOWEST donor-site morbidity and the fastest return to sport is:

• A Bone-patellar tendon-bone (BPTB) autograft
• B Hamstring tendon (4-strand semitendinosus-gracilis) autograft ✓
• C Quadriceps tendon autograft
• D Peroneus longus autograft

Explanation

Hamstring (4-strand gracilis-semitendinosus, also called DIDT) autograft is associated with lower donor-site morbidity compared to BPTB graft (which causes anterior knee pain, risk of patellar fracture, risk of patellar tendon rupture) and has equivalent functional outcomes for ACL reconstruction in most studies. Quadriceps tendon graft is an emerging option with good results. BPTB has historically been the 'gold standard' for graft strength and tunnel bone healing but higher donor-site morbidity limits its use in athletes requiring full-squat positions. Peroneus longus is a graft option for lateral ankle ligament reconstruction, not ACL.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.