treatment involves ligamentous reconstruction utilizing a variety of techniques and graft choices. The ACL is a type of ligament that is in the knee. The quadriceps tendon as an ACL graft has been used for quite some time, but has gained more popularity over the last 5 years as another excellent option. Previous attempts to make it better provided only temporary relief. During the immediate postoperative period after ACL reconstruction the graft fixation site, not the graft material itself, is considered the weakest link. The success rates between ACL grafts harvested from your own body are very similar and have the lowest failure rates. BEAR is a more recent approach to ACL repair which requires more research to evaluate the effectiveness of the procedure. Choosing the right ACL graft is even more important if you intend to return to playing a high level of sport which requires a lot of pivoting and twisting movements of the knee. options as to what tissue is used for the ACL graft (the three most common are patella tendon, hamstring tendon, and cadaver tendon) and each patient should consult with his or her surgeon to determine the best choice. The ACL does not heal very well, and an injury usually results in an unstable knee. GoalFunctional and anatomicalrestoration of ACL insymptomatic ACL deficiency 3. A reconstruction simply means a replacement of the ACL since repair currently does not work (see this link for exciting news regarding ACL repair). I was hit by a car on my bicycle near Horsetooth Reservoir in CO. Required fields are marked *. The graft is taken from your patellar tendon (aka patellar ligament) – the structure attaching your kneecap to your shin bone. It is also the “go to” graft of choice for AL revisions and multiple ligament knee injuries 4. The quadriceps tendon tissue has become more popular in recent times and is now considered to be a genuine alternative to the patella and hamstring grafts. Chapter 8 Graft Options for Anterior Cruciate Ligament Revision Reconstruction Lonnie E. Paulos, MD, Anastassios Karistinos, MD INTRODUCTION 229 SYNTHETIC GRAFTS AND AUGMENTATION DEVICES 229 Gore-Tex Ligament 230 Stryker Dacron Ligament 230 Kennedy Ligament Augmentation Device 230 ALLOGRAFTS 231 Graft Options 231 Disease … When it comes to an ACL reconstruction the research suggests that donor tissue has a significantly higher failure rate when compared to tissue taken from your body. A third option that has gained in popularity in recent years is using the quadriceps tendon. demographics. Therefore you need to ensure your surgeon is highly regarded within your community and that they perform many ACL reconstructions every single month. Better techniques now mean patients spend less time in hospital however once the nerve block wears off you will still need pain killer medication. All I can say is Dr. La Prade did an amazing job and I am not limited in any of my activites. The utilization of hamstring grafts is also very frequent worldwide and hamstring grafts often felt to be excellent grafts for those with lower-impact activities or lower demands. This graft is often utilized because it has bone on each end of the graft, which allows for more secure and earlier healing during the rehabilitation process. This includes choosing a trusted and highly credentialled surgeon to perform the reconstruction surgery, the ACL graft type and the most appropriate timing for the surgery. The main graft options for ACL surgery currently are to use either the patient’s own patellar tendon or hamstring tendons or to use a cadaver graft. In some cases where a donor graft has been used to create an ACL, the body has essentially rejected the tissue and revision surgery has been required. Plus to determine the levels of revision rates compared to the traditional ACL autograft option. It can happen when you slip in a puddle of mud or something even crazier. One of the key advantages of using a hamstring tendon graft is it avoids the common problem associated with using a patella tendon graft where pain is known to occur at the front of the knee. ACL reconstruction can be done with several different graft choices. Quadriceps tendon graft is a relatively new option but the short-term results are promising. In more recent times the quadriceps graft has started to gain in popularity as … So which ACL graft type should a person choose if they elect to undergo ACL reconstruction surgery? incidence. Quadriceps Tendon Graft ACL Reconstruction? To that extent, the type of ACL graft chosen for an ACL operation will often come down to your surgeon’s preference. The allograft tissue can come from death where a person has consented (or consent is provided through family) to donate his or her tissue to another individual to enhance their quality of life. The other autograft that can be used for ACL reconstruction is a quadriceps autograft. There are also some other important decisions that you need to make about your surgery. There are many variations of ACL reconstruction, all of which aim to give the patient the best functioning knee possible. The statistics indicate that the re-tear rate for ACL reconstructions can be as high as 20% for teens and up to 80% of patients will develop arthritis 15 to 20 years after surgery. Each of these choices has advantages and disadvantages. According to some sources, there are approximately 1 million allograft medical procedures in the United States every year and have been used for approximately 150 years. At Children's Colorado, we also offer a third option, called the quadriceps tendon autograft (also called the quad-tendon graft for short). Allografts are selected from cadaveric donors while autografts are taken from the patient’s own body. I am 5-months post surgery, and am doing great, stationary biking and exercising every day, no pain.You know you are seeing the best when you find out he has written over 500 medical journal articles - among many other accomplishments. Graft options in revision ACL The revision ACL procedure is considerably more challenging than the primary ACL procedure. BEAR stimulates a torn ACL to heal itself and eliminates the need for a tendon graft. Both of these have bone blocks at the ends, and the bone allograft blocks are a potential ‘weak link’ … The procedure is typically performed through arthroscopy which includes preparing the new graft, removing the torn ligament, and attaching the new tendon to bone for better fixation and healing. As part of the reconstruction a graft must be chosen and used. An ACL reconstruction is performed by an orthopedic surgeon and takes one to two hours to complete. An autograft is a tendon that is harvested from your own body and an allograft is harvested from a human cadaver. choices. Not having ACL surgery is a very realistic option that people do choose if the circumstances are right for them. Quadriceps Tendon Autograft The “new kid on the block” graft. Overall, using one’s own tissues for an ACL graft is the best option for the vast majority of patients. ACL reconstructions aim to produce a result that is close to the original structure as possible. TYPES OF ACL RECONSTRUCTION GRAFTS. This was devastating news after being a top triathlete (3rd in the world in my age group in 1989 & 1st nationally in my age group) and a big marathon runner. The first option is to use a portion of one’s patellar tendon along with a piece of bone from the knee cap and a piece of bone from the patellar tendon insertion site on the tibia (bone-patellar tendon-bone, or … Where is the ACL, and what does it do? 5 Key ACL Recovery Timeline Stages for Sports Athletes! ACL reconstruction surgery is an elective procedure. This answers all my questions! There are a number of ACL graft options available when a person is considering surgery to repair a torn Anterior Cruciate Ligament (ACL). In more recent times the quadriceps graft has started to gain in popularity as an alternative option. First, there is a difference between using one’s own tissues, an autograft, and using a cadaver’s tissues, called an allograft. These include the use of autologus hamstring or patellar tendon graft, cadaveric donor grafts and synthetic graft (LARS). I could not bear weight on my right side though I tried repeatedly, but finally I went and got an MRI and one of the orthopedic surgeons that I worked with was shocked when he saw the MRI result. 4010 W. 65th St. Bridge Enhanced ACL Repair (BEAR) is a relatively new technique which uses stitches and injection of the patients own blood to stimulate the healing of a torn ACL. Therefore of these three grafts, the tibialis anterior remains my personal favourite, and it is my opinion that, currently, the tibialis anterior tendon allograft is the absolute best option and gold standard graft choice for reconstructing an ACL.