What type of ACL Graft is best for me?

What is an Anterior Cruciate Ligament (ACL) Graft?

• When you tear your ACL, the majority of the time the surgeon is unable to use what is left of your ACL to repair. Which means they have to construct a new ligament from another source— this is why it is called an ACL reconstruction.

• A “graft” is simply the source of the new ACL and you have a few options to choose from.

Photo taken from Colorado Children’s Hospital

What type of Grafts are there?

• Quadriceps tendon graft

  • Probably one of the strongest grafts with lowest chances of retear

  • Can lead to chronic knee pain if not rehabbed properly

  • Less pain with long-term kneeling than patellar tendon

• Hamstring tendon graft

  • This is taken from your hamstrings on the inside part of your knee and tends to have a longer protection phase in the initial 6 weeks of rehab.

  • Less joint swelling, but leads to long term hamstring weakness (a big factors for ACL tears in the first place)

  • Can be a tough choice for Quad dominant sports (soccer, volleyball, etc) and further increase the strength imbalance in the knee

• Patellar tendon graft

  • A very strong graft but does leave more soreness/pain early on in the rehab process. This is taken from the middle third of your patellar tendon.

  • Can start strengthening slightly earlier in the rehab process with the right supervision

  • Tends to have some long term pain with kneeling.

  • May not be a good option for Adolescents still growing due to growth plates

• Allograft (cadaver graft)

  • A Cadaver graft is generally used on Active adults over the age of 35 and do not require an additional surgical site on your knee like the grafts above. These grafts are also used for recurring ACL tears to protect the quads and hamstrings from additional surgeries

  • One of the biggest cons is the failure rates because it comes from someone else, so there is a chance your body can reject it.

  • Tends to be less painful that other grafts

Is there any way they can use my Torn ACL instead of creating a new one?

• There is a relatively new ACL Procedure called the Bridge Enhanced ACL repair (BEAR), which utilizes your own torn ACL and repairs it with a surgical technique.

• This technique is reserved for very particular ACL tears and there is not much long-term data on them.

• If you think the BEAR technique may be right for you, consult your Surgeon

Photo courtesy of BioWorld

IF you have recently had an ACL tear, make sure you are informed about which Graft is the best choice for you and the activities you want to participate with. Make sure you find a Physical Therapy clinic that can help rehab you and get you back to everything you want to do!!

***Medical Disclaimer***- the information provided above is simply for information purposes and is not medical advice. Consult with your healthcare provider on the best ACL option for you.