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I'm going to have surgery to repair a torn ACL in my left knee. I know they are going to remove part of my hamstring tendon and use that in the procedure. But how do they hold the new piece of tendon in place until it heals?

Various tendon grafts are fixed or held in place with different techniques. The most common fixation device is the interference screw. The screw is bioabsorbable or biodegradable. This means that it doesn't have to be removed later. Another type of fixation device is the endobutton. A loop of polyester tape with a clasp at one end offers a way to secure the soft tissue to the bone. This type of fixation has good results with few problems or failures. Bioabsorbable crosspins can be used to hold a hamstring-tendon autograft to the femur (thigh bone). A femoral press-fit fixation may be used with the bone-patellar tendon-bone reconstruction. This is a way to avoid using screws. There are actually many graft fixation options. When you see your orthopedic surgeon at the next pre-op visit, ask him or her to explain to you just exactly how the procedure will be done. Your surgeon may even have a videotape of the surgical procedure you can watch ahead of time. Many of your questions may be answered this way.

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