Which graft should i use?!
Question: I'm about to have an acl surgery on my knee and i still haven't decided which graft i should use. if i use the hamstring tendon, will it affect my hamstring in the long run? aside from diseases, will the cadaver be strong enough to hold up my knee during sports (soccer)? how long is the recovery time for both. Is there a chance of rerupturing the hamstring tendon during rehab?
Answers: I'm about to have an acl surgery on my knee and i still haven't decided which graft i should use. if i use the hamstring tendon, will it affect my hamstring in the long run? aside from diseases, will the cadaver be strong enough to hold up my knee during sports (soccer)? how long is the recovery time for both. Is there a chance of rerupturing the hamstring tendon during rehab?
If you are an athlete and totally committed to rehab, the graft choice is not going to influence the recovery time. In general, recovery time is between 4-6 months, however it can be longer if you had other surgical procedures at the same time such as a mensicus repair.
Many of the orthopedic surgeons I work with no longer use the hamstring graft option. We are getting a better idea of the biomechanical implications of removing a portion of the hamstring. Even on the most basic level, it just does make sense to use it. The anterior cruciate ligament is a passive restraint against anterior tibial translation. Being a passive restraint, it cannot accomidate to different situations by itself. This is where the hamstring comes in. The hamstring is the dynamic restraint against anterior tibial translation. It performs the same function as the ACL, but you have some voluntary control over it and it can adapt to various demands. After surgery, your hamstrings are going to be the muscles protecting your new graft, why would you damage this natural protection. When using a hamstring graft, there is a loss of strength, that in some people may not return. You are also more likely to have a hamstring injury in the future.
In terms of an allograft (cadaver), some surgeons are reluctant to use them in athletes, but I believe that they are really one of the better choices (the best being contralateral grafts). Allografts can be processed in ways that an autograft cannot. They can be woven together to result in a quad bundled graft. These are extremely strong, much stronger than what can be obtained with an autograft. Recovery also tends to be less painful since there is no additional trauma from the graft harvest. Some surgeons may slow down rehab when an allograft is used, since allografts can become stretched out if physical therapy is too aggressive too soon.
about 2 months