This prospective multicenter MARS cohort study enrolled 1205 patients undergoing revision ACL reconstruction across 52 sites and 83 surgeons to determine whether graft choice — autograft versus allograft, and BTB versus soft tissue — predicts 2-year patient-reported outcomes, graft rerupture, and reoperation rates.
When planning revision ACL reconstruction, choose autograft over allograft whenever the anatomy allows — it reduces rerupture risk by more than half and improves sports function scores at 2 years.
If the patient is already on their third revision, counsel them explicitly: the risk of another rupture is 25 times higher than a first revision, regardless of graft choice.
This prospective multicenter MARS cohort study enrolled 1205 patients undergoing revision ACL reconstruction across 52 sites and 83 surgeons to determine whether graft choice — autograft versus allograft, and BTB versus soft tissue — predicts 2-year patient-reported outcomes, graft rerupture, and reoperation rates.
When planning revision ACL reconstruction, choose autograft over allograft whenever the anatomy allows — it reduces rerupture risk by more than half and improves sports function scores at 2 years.
If the patient is already on their third revision, counsel them explicitly: the risk of another rupture is 25 times higher than a first revision, regardless of graft choice.