Which ACL Graft is Best for You?

The decision to choose an ACL graft can be overwhelming. This week, we will focus on the pros and cons of the major graft options & share new resources that we put together for The Sports Docs Podcast on this topic.

I started a new You Tube channel with Dr. Ashley Bassett so we can now offer both audio and video content for our podcast. Our first video podcast reviews autograft and allograft options, the current literature, and how we make our graft choices. We hope you enjoy the new format. It is a patient-friendly episode we believe will help answer both clinician and patient questions effectively.  

On our first episode of Game Time, we tackle the age old question... 

Which ACL graft is best for me?

There are many graft options to choose from and we discuss the pros/cons of each choice in this episode!

Allograft is cadaver tissue, which comes from a human donor.

Allograft is a viable option for revisions and primary ACLs in patients older than 35 years of age.

✴️ It has the benefit of avoiding donor site issues from harvesting a graft (anterior knee pain, kneeling pain, hamstring weakness), decreased surgical time, smaller and fewer surgical incisions.

✴️ The biggest downside is the increased risk of graft failure and need for revision surgery in patients under the age of 35.

Autograft is the patient’s own tissue. Options include patellar tendon or “BTB”, hamstring tendon and quadriceps tendon (pictured in image 3).

✴️ Patellar tendon has a slightly lower rate of failure compared to hamstring but much more donor site issues (kneeling pain, anterior knee pain, fracture risk).

✴️ Young female patients (< 20) in particular have a significantly higher failure rate with hamstring autograft use, thought to be due to smaller hamstring size.

✴️ Quad tendon is a newer autograft with less donor site morbidity than patellar tendon and less graft size concerns than hamstring, especially in females, and is particularly promising.

This and more on our latest episode!

Listen

Author

Dr. Catherine Logan, MD, MBA Catherine Logan, MD, MBA, MSPT, is a sports medicine orthopaedic surgeon specializing in complex knee and shoulder surgery at Colorado Sports Medicine and Orthopaedics (COSMO) in Denver, Colorado. As a former physical therapist & trainer, Dr. Logan provides a distinct expertise in sports injury, prevention, and surgical management.