ACL graft sites, what's the difference?

There are usually 2 areas where a surgeon can take a graft to replace your ACL. The two areas are your patellar tendon or your hamstring tendons. If this is new information to you, refer to our previous post on some details about ACL surgery here.
When reading the differences listed below it is important to remember that your surgeon will choose the graft site for your ACL surgery. The good news is that our app, Curovate, for ACL rehabilitation has a protocol for hamstring tendon or patellar tendon grafts here.

Hamstring Graft Surgery (HT) Patellar tendon also called Bone-Patellar-Bone Surgery (BTB)
1. The operation takes more time and the tourniquette, which is a device used during surgery to limit blood flow in the leg, is on for longer2 1. The knee is stiffer after surgery2
2. The knee moves more freely front and back, when tested using a KT-1000 Arthrometer machine2, which is a device that measures front and back movement of your lower leg compared to your thigh. 2. More knee pain when kneeling on the ground3
3. Over a period of 15 years after surgery there were more reinjuries reported.3 3. Over a period of 15 years after surgery more stiffness and difficulty straightening the knee was reported3.
4. The need to do another surgery to address issues with the first surgery is called a revision surgery. The revision rates, for hamstring graft surgeries increases by 0.65% within 1 year and by 4.45% within 5 years4. 4. Revision rate after 1 year is 0.16% and revision rate after 5 years is 3.03% for patellar tendon graft surgeries4.
5. Hamstring muscle power reduced by 15%1. Muscle power is the maximum force you can apply in as short a time as possible.
6. Muscle strength reduces by 11% when straightening the knee2. Muscle strength is how much force a muscle can produce in a maximal effort.
7. There is more instability in the knee when force is applied2. Instability is undesirable movement in a joint.



References

Prateek Gupta

Prateek is currently a candidate for the Master of Physical Therapy from McGill University. He is excited to disseminate evidence-based information on rehabilitation and healthcare with Curovate.

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