[6,7] A study of surgeons in Italy showed a preference for hamstring autografts. ACL Hamstring Graft Protocol Physical Therapy protocols provided by Dr. LaFrance of Hamilton Orthopedic Spine & Sports Medicine. To solve this problem, many surgeons use hybrid grafting that involves augmentation of small hamstring autografts with allograft tissue. focus rehab on exercises that do not place excess stress on graft. Patella Tendon Autograft. ACL reconstruction can be done with several different graft choices. The hamstring graft is A strong graft. I recommend the hamstring graft. Therefore, the ACL must be reconstructed. Some surgeons use an additional tendon, the gracilis, which is attached below the knee in the same area. Some patients have small hamstring tendons however, which may compromise the clinical outcome of the autograft. Surgeons in the US most often use bone-patellar tendon-bone (BPTB) and 4-strand hamstring tendon autografts. GENERAL GUIDELINES Focus on protection of graft during primary re-vascularization (8 weeks) and graft fixation (8 â12 weeks) For ACL reconstruction performed with meniscal repair or transplant, defer to ROM and weightbearing precautions outlined in the meniscal repair/transplant protocol. The ACL graft is the type of tissue used to create the new ACL ligament . Table 2. Harvesting can be accomplished and reproducibly with the traditional anterior approach or remove a posterior approach using the minimally invasive hamstring harvest ⦠Gaining full knee extension early in the rehab process is crucial to prevent graft site adhesion. ACL Hamstring Tendon Autograft Reconstruction Protocol . 1. yenwen / Getty Images. Which ACL graft Would You Choose to Reconstruct the ACL of an 18 year old Athlete? S.S: My preference in young patients is to use autograft.Many recent studies, including the recent MOON studies, have demonstrated that autograft is superior to allograft, with significantly decreased risk of re-rupture, in a young athletic population.The risk of re-rupture approaches equal at about age 35. Also, ACL reconstruction may be done in conjunction with other Hamstring autograft; Quadriceps tendon autograft; Patella tendon allograft; Letâs look at some of the research behind each ACL graft choice. appropriate rehab. This creates a two- or four-strand tendon graft. For this reason, resisted hamstring curl should be held until 4-6 weeks post-op, and close attention should be paid to hamstring related symptoms through out the rehab process. (3) The needle is passed through the proximal part, grabbing and tensioning the distal part with the nonabsorbable suture. isometric quadriceps, or simultaneous quadriceps and hamstrings contraction. The semitendinosus hamstring tendon on the inner side of the knee is used in creating the hamstring tendon autograft for ACL reconstruction. Each of these choices has advantages and disadvantages. In addition, a hamstring ACL autograft , causes less pain at the time of surgery and has a smaller scar. The most common options include patellar tendon, hamstring tendon, and donor tissue (allograft). active knee motion between 35 degrees and 90 degrees of flexion. 4-strand graft preparation, (2) a nonabsorbable suture is passed in the middle and the tendons are folded. isometric hamstring contractions at any angle. Arthrex offers the most advanced techniques and instruments for hamstring harvesting and preparation. ACL tears reconstructed with a hamstring graft is excellent. Arthroscopic reconstruction is the standard approach to treating ACL tears, but the optimum graft choice remains controversial. Background: Hamstring tendon autografts are commonly used for primary anterior cruciate ligament (ACL) reconstruction.
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