The most popular ACL graft used in orthopedic surgery is the patellar tendon graft (PTG). This graft has been considered the gold standard for ACL reconstruction for many years. It involves harvesting a portion of the patient’s own patellar tendon, along with bone plugs from the patella and tibia, to create a new ACL.
There are several reasons why the PTG is widely preferred by surgeons. Firstly, it has been shown to have excellent long-term outcomes and high success rates in restoring knee stability. Numerous studies have demonstrated the durability and strength of the PTG, making it a reliable choice for athletes and active individuals.
Additionally, the PTG allows for early mobilization and faster recovery compared to other graft options. The bone plugs at each end of the graft provide good initial fixation, allowing for immediate stability of the knee joint. This enables patients to start rehabilitation sooner, leading to quicker return to sports and activities.
However, while the PTG remains a popular choice, there has been a shift in preference for certain patient populations. In younger athletes, especially those involved in high-demand sports such as soccer or basketball, hamstring grafts have gained popularity. This is because hamstring grafts are believed to better preserve muscle strength and function compared to PTG.
Hamstring grafts involve harvesting a portion of the patient’s own hamstring tendons, typically the semitendinosus and gracilis tendons. These tendons are then prepared and used to create a new ACL. The advantage of hamstring grafts is that they result in less anterior knee pain compared to PTG, which can be a concern for some patients.
Furthermore, in older patients or those with comorbidities that may affect healing, cadaver grafts, also known as allografts, are often preferred. These grafts are obtained from deceased donors and are processed and sterilized before being used for ACL reconstruction. Cadaver grafts provide a viable alternative to using the patient’s own tissue and can be beneficial in certain situations.
It’s important to note that the choice of graft for ACL reconstruction is highly individualized and depends on various factors, including the patient’s age, activity level, and specific needs. Surgeons will consider these factors, along with their own experience and expertise, when determining the most appropriate graft option for each patient.
While the PTG remains the gold standard for ACL reconstruction, there has been a shift in preference for certain patient populations. Hamstring grafts are commonly used in younger athletes to preserve muscle strength, while cadaver grafts may be preferred in older patients or those with comorbidities. The choice of graft is a decision made by the surgeon based on the individual patient’s needs and circumstances.