Friday, February 12, 2016

New option for ACL reconstruction

Anterior cruciate ligament, or ACL, tears can have a devastating impact on an athlete's ability to return to play.  Its important role in stabilizing the knee almost universally requires surgery to restore its function, and fortunately most patients will return to play after recovery.  I wanted to briefly discuss the use of a new graft option available for ACL reconstruction and why I feel it can be a great option for getting you back on the field.

ACL reconstruction surgery entails replacing the torn ACL with a graft.  One option is to obtain a sterile graft from a cadaver, or an allograft.  This can be a great option as it entails much smaller incisions, less initial pain and a quicker earlier rehabilitation.  The graft does take longer to heal, and there is an elevated risk of rerupture mainly in the young athlete.  The second source of graft material is from the patient's own body, or an autograft.  Benefits of this option include faster graft healing, no chance of disease transmission, and lower rerupture rates in young athletes.  Some downfalls include larger incisions and injury or weakness in the structures from where the graft is harvested from, primarily the hamstrings and patella tendon.

Recent research has identified a new source of graft, the quadriceps tendon.  This stout tendon connects the thigh muscles to the kneecap.  In obtaining this graft the surgeon only has to take a small piece of the quadriceps tendon, leaving a significant portion behind which likely lessens the chance for weakness in this area after surgery.  The very thick tendon is also much stronger than the traditional gold standard of the patella tendon, and does not typically require sawing the kneecap which can lead to pain after surgery and possibly fractures.   It is my belief that this graft option can provide a great alternative to patients worried about anterior knee pain after ACL reconstruction but who would like to use their own tissue, especially in young athletes.   Utilizing the newest technology and research here at Floyd Memorial, I believe this technique can offer yet another tool for getting our patients back in the game!

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