OBJECTIVE: To compare the clinical results of anterior cruciate ligament reconstruction (ACLR) with autografts and that with hybrid grafts of the same diameter. METHODS: This study retrospectively included 102 patients who underwent ACLR from August 2017 to July 2019. According to graft type, the patients were divided into an autograft group (58 patients) and a hybrid graft group (44 patients). All grafts were 8.0 mm in diameter. The failure rate, knee kinematics with 6 degrees of freedom (DOFs), signal/noise quotient (SNQ), the Lachman test, pivot-shift test, Lysholm score, Tegner activity score, and International Knee Documentation Committee (IKDC) score were compared in each group after a minimum 2-year follow-up. RESULTS: There was no significant difference in the failure rate between the autograft group (1.72%) and the hybrid graft group (2.27%) (P >
0.999). The SNQ values of the autograft group (16.42 ± 5.29 and 18.52 ± 5.30) at the middle and proximal sites were lower than those of the hybrid graft group (12.13 ± 5.62 and 16.35 ± 4.64
P = 0.020 and P <
0.001, respectively). In the autograft group, the results of range of motion at 6 DOFs and tibiofemoral kinematics at 5 DOFs (except internal-external rotation) were similar to those of the hybrid graft group (P >
0.05). The Lysholm score, Tegner activity score, IKDC score, Lachman test, and pivot-shift test showed no differences between the two groups (P >
0.05). CONCLUSIONS: Autograft in ACLR has better graft maturity than hybrid grafts, but their kinematic characteristics are similar. CLINICAL TRIAL REGISTRATION: ChiCTR2000037869.