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I figure a fair few people on this site have had ACL reconstruction. Im having surgury here soon and I have the option to choose where my new ACL comes from (Patellar Tendon or Hamstring.)
Anyone else get the option care to share what you picked and why? Any issues down the road with skiing or anything?
Even if you didnt get to pick let me know if you know. It kind of feels like a life changing decision right now!
Any help at all is super helpful! thanks.
I had a hamstring graft, 341 days later it feels rock solid, your hamstring will be weak for a little bit after surgery, thats where physical therapy comes in...
From what i've heard the patella graft isn't that good if you're an active distance runner - which I am, so I went with the hamstring graft.
Good luck OP!
All about that patella autograft, nothing beats the solidity of bone plug end pieces on the graft... Definitely will be a more painful recovery because they are harvesting chunks of bone from your tibia and patella but in the long run there is a slightly lower retear rate in young active individuals with a patella graft also less prone to stretching due to the bone plugs. This is what NFL football players get, if it is solid enough for them it should do fine for us tiny little skiers. I'm at 6months out on a patellar tendon autograft starting to get some tricks back and the knee feels solid. Ultimately though it would be wise to ask your surgeon which one he is more comfortable doing if they do 1000 hamstring grafts for every patellar graft then they probably do a better job on the hamstring procedure. Also being dedicated to your rehab and physical therapy is much more important than which graft you get.
Both tendons are strong enough to replace the ligament. Younger surgeons were often trained to do hamstrings, whereas older do patellar - though this is not universal.
Patellar has no loss in hamstring strength so quicker rehab, higher risk of patellar tendonitis ('jumpers knee' / patello-femoral pain syndrome. As mentioned, NFL players often do this (they actually take the graft from the good knee so that they can immediately rehab = quickest return to play, though obviously a downside is you have both legs to rehab). Hamstring has a smaller scar, less chance of tendonitis, more rehab required.
Either way is fine, just rehab hard since that'll determine your outcome much more than the specific operation.
I had the patellar and I'm very happy with the results. Little to no lasting discomfort. I can kneel, which is a thing some can't after patellar. I had a 5.5 month rehab before jumping back to where I was before with skiing (albeit with a brace). I spoke to my surgeon about it and he wasn't fussed what type of graft I got in that he was confident and happy doing both. The patellar tendon regrows in most cases as opposed to the hamstring which doesn't. I would look up research and studies and further medical opinion though. This isn't a decision NS can make for you.
garrett.Hamstring if you dont want your patellar tendon to hurt for forever.
12 years out and my patella tendon is fine.
My patella graft is great. The only pain I have is from occasional scar tissue. The only issue is the rehab is very long. I have heard it is not used as often anymore. I don't ski as well as I used to but that is because I lived in Tahoe when I had it done and I am now a weekender skiing Mammoth 40 days a year. I am glad I did the patella but I have heard the cadaver is a much faster recovery. I don't know anything about the cadaver though, so don't take that as an endorsement.
Overall I am happy with how my patella turned out.
Just had mine done in feb i had a hamstring graft that being said there are pros an cons to any of the options.
Hamstring Graft better in the long run but has a longer recovery time due to the fact they are harvesting a new ACL from it. Essentially injuring yourself again, but in my opinion is a better option due to the fact that its your body part going back into your body.
Patella Graft is the "older" style done, personally i don't know anyone who has gotten one. That being said what i found online is that the recovery time is a little faster than the hamstring also can be just as strong as the Hamstring graft but can cause knee pain down the road if you like crawling on your knees i wouldn't recommend it.
Cadaver Graft would be my last option its not a body part from your body an in certain cases they don't take to your body. I wouldn't want to have two surgeries when you can get it done in one. Some people get them an never have a problem again though. The plus is the recovery time is wayyy shorter than the other two because they aren't harvesting anything.
With all that being said i am not a doctor im a ski bum who is a remote pilot from 6-3 mon thru friday haha good luck an wish you a fast recovery OP!!!!
Pegel18Yo, what kind of brace did you get? i wont be skiing until 7.5 months after surgey, but looking into braces to be safe.
I got a Donjoy Armor which they sell as the strongest brace available. I think they have brought out a new version with Fourcepoint which is better now, but when i got mine the armor was pretty much the best off the shelf option for use in skiing. I've been pretty pleased with it and have continued using it for another season now but my muscle mass recovery is becoming a bit of a problem now that the straps no longer properly reach because of the size that fit me best post-op.
garrett.Hamstring if you dont want your patellar tendon to hurt for forever.
dan406012 years out and my patella tendon is fine.My patella graft is great. The only pain I have is from occasional scar tissue. The only issue is the rehab is very long. I have heard it is not used as often anymore. I don't ski as well as I used to but that is because I lived in Tahoe when I had it done and I am now a weekender skiing Mammoth 40 days a year. I am glad I did the patella but I have heard the cadaver is a much faster recovery. I don't know anything about the cadaver though, so don't take that as an endorsement.
Overall I am happy with how my patella turned out.
Agreed. I'm 9 years out from mine and my patellar has no pain. Kneeling hurt like a bitch for like 2 years post surgery, but have had no issues since. I skied a 140 day season starting 9 months after surgery and 160 the following year. Like I'm sure you've read, regardless of which procedure you go with, work your ass off during PT, bike a LOT, and you'll be good to go.
I looked pretty hard into this a few years ago. The conclusion I reached was that for ultimate strength and minimal impact on other bits of you an allograft (cadaver donor) is the way to go if you don't mind having bits of a dead dude inside you. I think the edge actually went to the Achilles allograft for outright strength.
If you want an autograft, patellar is the stronger one due to the bone plugs.
But as people have already said the biggest factor is going to be whatever your surgeon is most comfortable with, followed by how good you are with your prehab/rehab.
In my case (partial ACL tear) we decided to just leave it alone and wait until I nuke it completely, which hasn't happened yet... touch wood.
I_liketobutterLike I'm sure you've read, regardless of which procedure you go with, work your ass off during PT, bike a LOT, and you'll be good to go.
100% correct. I can't stress enough how much I agree with this. You need to attack physical therapy like a madman, that is how you recover and get back to what you want to do.
I_liketobutterwork your ass off during PT, bike a LOT, and you'll be good to go.
dan4060You need to attack physical therapy like a madman, that is how you recover and get back to what you want to do.
went with the patella graft and im just at 18 weeks out right now and starting to feel strong still some pain but definitely gets better.(hiked red rocks the other night.) Been working my ass of with therapy, not cleared to ride a bike outside yet but been doing miles on miles everyday on the inside one, should be running in 2 weeks! should be on skis again in November. Hoping to get back skating before then to help with balance, and all that.
Download-My-AppsThe best option is always what the surgeon is most comfortable with.
this times 10000
the success of the reconstruction is 50% how well the surgeon does the graph and 50% you doing a good PT.
no matter how hard you work on your PT if the surgeon fucks up it will get torn again.
so really, since both techniques are similar (the patella one might be a bit more painful from what i understand) just go with the one your surgeon has practiced the most.
i personnaly went with a patella and even though the recuperation was painful my knee was like new and it didnt feel weak during the next ski season.
Gharfthis times 10000the success of the reconstruction is 50% how well the surgeon does the graph and 50% you doing a good PT.
no matter how hard you work on your PT if the surgeon fucks up it will get torn again.
so really, since both techniques are similar (the patella one might be a bit more painful from what i understand) just go with the one your surgeon has practiced the most.
i personnaly went with a patella and even though the recuperation was painful my knee was like new and it didnt feel weak during the next ski season.
yup, I busted my ass in the gym and with a PT after my hamstring graft. Still failed. Luckily my work in the gym made my knee strong enough to not need an ACL #noaclsnoproblem