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Getting a Bent Knee Up on Best Graft Choices for ACL Surgery

When faced with a difficult medical decision you might ask, "Doctor, what would you do?" In the case of repairing the anterior cruciate ligament (ACL) of the knee, doctors may have an answer to this question. Presently, there are two different ways to repair a torn ACL. Both methods have good and bad points.

Since the final result seems to be the same, comfort may be the deciding factor. One method removes tissue from the front of the knee to transplant it to the other knee. This is called a patellar tendon graft. The donor site where the tissue was taken is commonly painful. Kneeling or walking on the knees is often painful and even impossible for some people.

This is a big problem for patients who have to be on their knees a lot -- for example, carpet layers, house cleaners, gardeners, construction workers, and mothers with small children. Thankfully, there are other ways to do this operation.

Donor tissue can be taken from the hamstring tendon along the inside edge of the knee. There's less pain after the operation when the hamstring graft is used. Range of motion, strength, and function are also just as good two years after the operation with this method. For this reason, some doctors are recommending the hamstring tendon graft over the patellar tendon graft for ACL repairs.

References: Lars Ejerhed, MD, et al. Patellar Tendon or Semitendinosus Tendon Autografts for Anterior Cruciate Ligament Reconstruction? In The American Journal of Sports Medicine. January/February 2003. Vol. 31. No. 1. Pp. 19-25.

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