ACL Series - Graft Choices - Quad tendon graft is here! #LaudtheQuad

A common question when facing ACL reconstruction is - which graft is the best? Typically the choice was between the Patellar Tendon Graft and the Hamstring Graft.

Let’s start with the basics.

What is a Graft?

A graft is defined as a “piece of living tissue that is transplanted surgically”. In the case of an ACL graft - the ACL (anterior cruciate ligament) is not “fixed” it is “reconstructed” with new tissue.

An autograft means it comes from your body (patellar tendon, hamstring tendon, quadriceps tendon)

An allograft means it comes from a donor (a cadaver) - it is not from your own body.

Here is a summary of the graft choices

Here are my personal recommendations.

For active individuals if your surgeon does the quad tendon graft, this is showing to be the best! Capital Region it is here, select surgeons are using it. If they do not - patellar tendon graft is favored in strength long term.

For older individuals or inactive individuals - I still recommend that an autograft is used over an allograft simply due to the fact it is from your own body and not a cadaver. But in cases where short term recovery is a concern - an allograft will help with the least post-surgical pain and simply get someone moving.

The importance of rehab

And then comes my obviously plug for rehabilitation. Reconstructing the ACL is the first part of the process but rehabilitation is crucial. Excellent, focused, structured rehab that motivates you, improves your overall fitness, and builds back your function is crucial to the success of this surgery.