A study published in this month's AJSM compared the long term (17 year) outcomes between ACL reconstructions with BTB autograft and hamstring autograft.Graft choice for ACL surgery is an interesting topic in the sports medicine world. For this reason, resisted hamstring curl should be held until 4-6 weeks post-op, and close attention should be paid to hamstring related symptoms through out the rehab process. Which ACL graft Would You Choose to Reconstruct the ACL of an 18 year old Athlete? - ACL biomechanics; - graft tunnel sites / isometry: - hamstring ACL reconstruction is an alternative to bone patellar bone graft fixation; - size and strength of graft: - double looped hamstring graft is more than twice as strong as normal ACL, as compared to bone patella bone (which is 1.3 isometric hamstring contractions at any angle. With the incidence of ACL ruptures continually increasing, this is a common injury seen by orthopedic sports surgeons and one that draws a lot of … focus rehab on exercises that do not place excess stress on graft. A hamstring autograft is one of the strongest grafts used in an ACL reconstruction. ACL reconstruction can be done with several different graft choices. Some patients have small hamstring tendons however, which may compromise the clinical outcome of the autograft. Each of these choices has advantages and disadvantages. Some surgeons use an additional tendon, the gracilis, which is attached below the knee in the same area. isometric quadriceps, or simultaneous quadriceps and hamstrings contraction. The hamstring graft has a cosmetic type and small incision. Arthroscopic reconstruction is the standard approach to treating ACL tears, but the optimum graft choice remains controversial. An ACL tear treated with a hamstring graft gives great results. The semitendinosus hamstring tendon on the inner side of the knee is used in creating the hamstring tendon autograft for ACL reconstruction. To solve this problem, many surgeons use hybrid grafting that involves augmentation of small hamstring autografts with allograft tissue. S.S: My preference in young patients is to use autograft.Many recent studies, including the recent MOON studies, have demonstrated that autograft is superior to allograft, with significantly decreased risk of re-rupture, in a young athletic population.The risk of re-rupture approaches equal at about age 35. Gaining full knee extension early in the rehab process is crucial to prevent graft site adhesion. Harvesting can be accomplished and reproducibly with the traditional anterior approach or remove a posterior approach using the minimally invasive hamstring harvest … Background: Hamstring tendon autografts are commonly used for primary anterior cruciate ligament (ACL) reconstruction. [6,7] A study of surgeons in Italy showed a preference for hamstring autografts. ACL Hamstring Tendon Autograft Reconstruction Protocol . The most common options include patellar tendon, hamstring tendon, and donor tissue (allograft). active knee motion between 35 degrees and 90 degrees of flexion. 1. yenwen / Getty Images. ACL Hamstring Graft Protocol Physical Therapy protocols provided by Dr. LaFrance of Hamilton Orthopedic Spine & Sports Medicine. GENERAL GUIDELINES Focus on protection of graft during primary re-vascularization (8 weeks) and graft fixation (8 –12 weeks) For ACL reconstruction performed with meniscal repair or transplant, defer to ROM and weightbearing precautions outlined in the meniscal repair/transplant protocol. As this technique is considered to be better to prevent anterior knee pain, it is often indicated in patients who kneel on a regular basis (such as cheerleaders, wrestlers, plumbers, and gardeners). The ACL graft is the type of tissue used to create the new ACL ligament . Secondly, obtaining the hamstring occurs with a tendon stripper. appropriate rehab. Surgeons in the US most often use bone-patellar tendon-bone (BPTB) and 4-strand hamstring tendon autografts. This creates a two- or four-strand tendon graft. Thirdly, I then prep the graft on a device called a graft master. Also, ACL reconstruction may be done in conjunction with other Arthrex offers the most advanced techniques and instruments for hamstring harvesting and preparation.

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