When a patient is undergoing ACL reconstructive surgery, there are a variety of options available. Most of these graft choices have a high success rate and allow patients to return to their pre-surgery condition. The difference in graft harvesting techniques, not so much the outcomes of the reconstruction, is what determines an orthopedic surgeon’s choice regarding which graft to use. The same graft may not be appropriate for two different patients with the same type of injury, so the choice of graft is very much a case by case basis. Patients who understand a bit about graft choices can see what their options are when it comes to ACL reconstruction surgery.
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ACL Surgery Graft Choices
Once the patient decides to proceed with anterior cruciate ligament reconstruction, he/she must then choose which graft to use to recreate the new ligament. Several options exist including:
- Autograft – Tendon taken from the patient’s own body at time of surgery
- Allograft – Donor tissue prepared and stored in a certified tissue bank
- Xenograft – Tissue taken from another species (not currently utilized for ACL surgery)
- Synthetic graft -Largely historical (and possibly an option in the future)
Autologous tendon grafts (autografts) are portions of tendon taken from around the knee that are used to reconstruct the injured ligament. Recall that ligaments connect bone to bone but tendons connect muscle to bone. ACL surgery takes advantage of the body’s ability to incorporate tendon tissue into the anatomic anterior cruciate ligament attachments and convert it to healthy ligament tissue over time (typically 12-18 months). The body completes this transformation somewhat more reliably using autologous tissue. For this reason, many surgeons still consider this type of reconstruction as the “gold standard.” However, as mentioned elsewhere, in many athletic populations the outcome of surgery is no different using autografts or allografts.
Next, please read about Post Operation Knee Rehabilitation.