ACL Graft Choices

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DragonflyF15
DragonflyF15 Posts: 437 Member
in Fitness and Exercise
I am going to have to get my ACL reconstructed, along with a few other things for a knee injury, and I have a couple of different options to go for. Just curious of those who have had this procedure, which did you choose, why and how has it been working out for you/pros cons. Mainly I'm down to Patellar graft and Allograft/Cadaver. I've had minor knee surgeries before, but nothing like this, so this is going to be a challenge, so any advice on healing/dealing will be greatly appreciated too! Thanks!

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  • jonelaw
    jonelaw Posts: 28
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    I am a PT in New England and have worked with many ACL patients postoperatively. I would personally avoid a patellar tendon graft as there is a high incidence of chronic patellar pain and problems following. It has been years since I have worked with anyone who had a patellar tendon graft. They just aren't done very often anymore. My first choice would be a cadaver graft as the rehab protocol is a little faster (at least with the surgeons I work with). A hamstring tendon graft would be my second choice though people tend to have some significant pain from the donor site initially. You also are not able to use weights for your hamstrings for 4-6 weeks following surgery.
  • bostonwolf
    bostonwolf Posts: 3,038 Member
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    I had a patella graft done 20 years ago. no real problems since except I can't really kneel on that knee wihtout a pad or towel because the screw holding the graft presses into the knee uncomfortably.

    if I had it to do again I'd probalby do the cadavar graft. It was relatively new when I had it done so I chose not to go that way. The biggest benefit is that it leaves the rest of your leg intact.
  • tri10806
    tri10806 Posts: 192 Member
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    I've had both ACLs done by patella graft. Right one in 1990 and left one in 1996. I had my right knee scoped twice for meniscus tears and clean up before that. I played league and tournament tennis 3-4 times a week from 1991 to 2005. I started doing triathlons in 2006 and have run 10 ultra trail races in the last 2 years. I don't want to jinx it; but they seem to be holding up well.

    I recommend finding a good sports medicine clinic (a doctor that understands sports is a must). My surgeon in Georgia was the team physician at UGA and my doctor here in town is an Ironman triathlete. Follow your rehab schedule to a T. Give it time to heal properly and you should be good.
  • DragonflyF15
    DragonflyF15 Posts: 437 Member
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    Thanks! I'm starting to lean more towards the cadaver as I'm reading more on it. I do alot of kneeling with my job (horticulturist/arborist) and patella graft seems to have some cons for prolonged kneeling. It's more expensive though and unfortunately insurance is not going to cover this injury, so it's out of pocket. The doc I picked out mainly cause he's worked on a few USA Olympic teams and seemed to be more sports minded and understand my active life and job. Not looking forward to it, but it is what it is and will do everything possible that I can to heal properly and be healthy :) Again, thanks for some input!
  • shade0343
    shade0343 Posts: 59 Member
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    Mine was a patella tendon graft. It was recommended at the time. The reason given was there were issues with making sure of safety. Early on there were problems with HIV and Hepatitis transmission from donor grafts. I'd make sure that is not an issue. I still have some sensitivity where they took the graft. It only affects me on hard surfaces.
  • DavPul
    DavPul Posts: 61,406 Member
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    Depends on what your activity level is. If you don't partake in a lot of athletic activities the cadaver route is fine. The patella graft is more involved and has longer healing time but is usually stronger and recommended for younger people or those that play sports. I went patella route and my knee is stronger than before the injury.

    Note: I did have a serious complication during the healing, but that was specific for me and not indicative of the procedure. I think.
  • DragonflyF15
    DragonflyF15 Posts: 437 Member
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    Depends on what your activity level is. If you don't partake in a lot of athletic activities the cadaver route is fine. The patella graft is more involved and has longer healing time but is usually stronger and recommended for younger people or those that play sports. I went patella route and my knee is stronger than before the injury.

    Note: I did have a serious complication during the healing, but that was specific for me and not indicative of the procedure. I think.

    That indeed is one of the pros for the patella graft, it takes longer to heal, but when it does, it's usually 90-95% whereas the cadaver is 85-90%. The risk too with cadaver is you don't know what kinda of shape or how old the donor was. I am fairly active, but I do alot of kneeling with my job (horticulture/landscaping) and many had issues with that when going the patella route. I also do alot of biking, hiking, and some running. Decisions decisions...

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