
A meta-analysis of 27 studies evaluated the long-term outcomes (≥5 years) of quadriceps tendon (QT), hamstring tendon (HT), and bone–patellar tendon–bone (BTB) autografts in anterior cruciate ligament reconstruction (ACLR). BTB had the lowest failure rate (6.4%), followed by QT (9.1%) and HT (12.7%). Patient-reported outcomes were similar across all grafts. However, limited long-term data on QT suggests it cannot yet be recommended over HT or BTB for primary ACLR.
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