ACL Grafts in the young patient
Studies have shown that allograft fails at a high rate in the young patient and therefore, people less than 30 years old should only use their own tissue (autograft) unless they have had previous surgeries that have used up the grafts or connective tissue disorders such as Marfan’s syndrome or Ehlers Danlos syndrome. There are two main graft choices in the autograft category, hamstring or patella tendons. Both have their own pros and cons.
Do you make a living playing sports or get a scholarship playing sports?
Yes – Patella Tendon No- Either
Do you often kneel for work (roofer, plumber, etc) or sports (wrestling, catcher) or need to get into an extremely deep squat?
Yes – Hamstring tendon No- Either
[one_half]Hamstring:
Pros
- Strong graft material
- It is your own tissue
- Small surgical scars
- Proven track record and reliability
Cons
- 9 month incorporation time
- Graft fixation is weakest link
- Tendon to bone healing
- Graft harvest pain [/one_half]
Pros
- Strong graft tissue
- Bone to bone healing and strong fixation
- Fastest return to play (6 months)
- It is your own tissue
- Proven track record and reliability
Cons
- Possibility of patella fracture
- Up to 10% of patients will have chronic pain in the knee cap espcially with kneeling or deep knee bends
- Largest of surgical scars
- Graft harvest pain[/one_half_last]