Current and future of anterior cruciate ligament reconstruction techniques

Table 1 Characteristics of various autograft materials

	Hamstrings	BTB	Quadriceps
Cross-sectional area	Good to excellent	Fair to good	Good to excellent
Mechanical strength	Good	Good to excellent	Excellent
Adjustment of graft length	Possible	Difficult	Easy
All-inside technology	Easy	Sometimes difficult	Easy
Preservation of remnant	Possible	Sometimes difficult	Sometimes difficult
Double bundle	Easy	Difficult	Possible
Graft fixation
Femoral	Cortical button	Interference screw	Interference screw
		(metalic > bioabsorbable)	(metalic > bioabsorbable)
		Cortical button	Cortical button
Tibial	Cortical button	Interference screw	Cortical button
	Interference screw	(metallic ≥ bioabsorbable)	Interference screw
	(metalic < bioabsorbable)
	Post fixation
Complication	Nerve injury	Patellar fracture	Patellar fracture
	(infra-patellar branches of the saphenous nerve)
	Decrease of Flexor muscle strength	Kneeling pain
		Anterior knee pain
		Decrease of extensor muscle strength	Decrease of extensor muscle strength
Indication
Recommend	Amateur athlete	Amateur and professional athlete	Amateur and professional athlete
		(high-intensity sports)	(high-intensity sports)
			Revision surgery
Not recommend	Ballet dancer	Wrestler, Judo, Karate

BTB: Bone–patellar tendon–bone.