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Two Good Options for ACL Grafts

Doctors have options for reconstructing a torn anterior cruciate ligament (ACL). Two methods are used most often. The torn ligament can either be replaced by a graft from the patellar tendon on the front of the knee, or by agraft from the hamstring tendon on the inside edge of the knee. There are pros and cons with each method.

In the past hamstring tendon grafts were doubled over to increase their strength. In this study the tendon was quadrupled to give make it even stronger. Also, doctors used a small piece of bone attached to the tendon, called a bone plug.

Results showed that pain was higher among patients who got a patellar tendon graft, and they reported more pain with kneeling. When this method was used, most patients (80 percent) had to stay in the hospital longer than 24 hours because of pain. Otherwise there weren't any major differences between the two groups.

The authors report a high number of athletes had good results with either method. There was one important difference. Only 60 percent of the athletes returned to their sports activity at the same level as before the injury--regardless of the graft used. This is an area for further study. The authors suggest that patients with knee straightening problems or patellar tendonitis should consider the hamstring graft instead of the patellar tendon graft.

References: Alberto Gobbi, MD, et al. Patellar Tendon Versus Quadrupled Bone-Semitendinosus Anterior Cruciate Ligament Reconstruction: A Propective Clinical Investigation in Athletes. In Arthroscopy. July/August 2003. Vol. 19. No. 6. Pp. 592-601.

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