ACL Injury: Types of graft
Anterior cruciate ligament (ACL) injury is a common and serious injury that affects many athletes, especially those participating in high-impact sports such as soccer, basketball, and football. The ACL is an essential ligament in the knee that helps to keep the knee stable and prevent the tibia from sliding out from under the femur. When an ACL is torn, it can lead to instability, pain, and a decreased ability to perform physical activities.
Fortunately, ACL reconstruction surgery is an option for individuals with a torn ACL. During this surgery, a new ACL is created using a graft. There are several types of ACL grafts, each with its own pros and cons. In this blog, we will explore the different types of ACL grafts and their characteristics.
Autografts Autografts are grafts that are taken from the patient's own body. There are three common autografts used in ACL reconstruction: a. Hamstring autograft: This graft is taken from the patient's own hamstring tendons and is commonly used for ACL reconstruction. It is a popular option due to its excellent biomechanical properties and low risk of donor-site morbidity. b. Patellar tendon autograft: This graft is taken from the patient's patellar tendon and is the most commonly used autograft. It provides excellent biomechanical properties and is easy to harvest. However, there is a risk of patellofemoral pain syndrome. c. Quadriceps tendon autograft: This graft is taken from the patient's quadriceps tendon and is a less commonly used autograft. It is used when other autografts are not available or when the patient has a contraindication to using other autografts.
Allografts Allografts are grafts that are taken from a donor and stored for later use. There are two common allografts used in ACL reconstruction: a. Cadaveric tendon allograft: This graft is taken from a cadaver and stored for later use. It is a popular option due to its availability and low risk of disease transmission. However, there is a risk of graft failure due to the age of the donor tissue. b. Fresh frozen allograft: This graft is taken from a living donor and frozen for later use. It provides excellent biomechanical properties and is less likely to fail compared to cadaveric tendon allografts. However, it is more expensive and less available than cadaveric tendon allografts.
In conclusion, there are several types of ACL grafts available, each with its own pros and cons. The choice of graft will depend on the patient's specific needs and the surgeon's preference. Regardless of the type of graft used, it is essential to follow the postoperative rehabilitation protocol to ensure a successful outcome.
References:
Brown JE, Bachus KN. Autograft and allograft options for anterior cruciate ligament reconstruction. J Am Acad Orthop Surg. 2010 Sep;18(9):560-9.
LaPrade RF, Wentorf F, Bonutti PM, et al. A systematic review of hamstring autografts compared with patellar tendon autografts in anterior cruciate ligament reconstruction. Am J Sports Med. 2006 Jul;34(7):1153-62.
Cole BJ, Nguyen AD, Farjo LA, et al. Anterior cruciate ligament reconstruction with quadriceps tendon autograft: a systematic review. Arthroscopy