There are multiple options with respect to the choice of the graft that can be used for ACL reconstruction. I am proficient and have extensive experience in the use of all the possible graft choices. During your consultation with me I will discuss the graft choice with you.
- Autograft (your own tissue): This is considered the gold standard and is always my preferred option. There are 3 options:
- Hamstring tendon graft: usually two of the medial hamstring tendons are used (semitendinosis and gracilis). The hamstring tendons will regenerate but a 5-10 % loss of power will remain in these two muscles even after full rehabilitation. This can lead to a slight loss of acceleration from a standing start.
- Patellar tendon graft: A bone block is harvested from the patella (kneecap) along with the central third of the patella tendon and a bone block from the tibia. There is a small chance of anterior knee pain after full rehabilitation.
- Quadriceps tendon graft: A bone block is harvested from the patella along with the central third of the quadriceps tendon. This is a very strong graft but the harvest of this graft leaves a longer scar over the front of the knee.
- Allograft (donor tissue):
- Tissue bank: The tissue from the tissue banks in South Africa is gamma irradiated for sterilization purposes. This structurally weakens the tendon tissue and leads to less reliable results after ACL reconstruction.
- Parent to child donor: I have performed this successfully in a young high level sprinter where any graft harvest could lead to a loss of acceleration.
- Artificial graft (synthetic materials):