Anterior cruciate ligament reconstruction in elite and professional athletes: does graft choice influence return to sport and failure rate? A systematic review and meta-analysis

Approximately 80% of elite athletes RTS after ACL reconstruction, with an overall re-rupture rate of 7%. Hamstring/peroneus combined with a LEAP demonstrated superior RTS outcomes compared with other grafts, while re-rupture risk remained comparable. These findings suggest that while graft choice may influence RTS outcomes in elite athletes, the addition of a LEAP appears to further enhance RTS rates, particularly in high-demand sports.