When young, active athletes tear their ACL (anterior cruciate ligament), it usually needs surgery. Although a very small percentage of ACL tears can be repaired, the vast majority need to be reconstructed completely with a new ligament. Surgeons have known for some time that allograft (graft from donors) has a higher failure rate than autograft (the patient’s own graft). Common areas to harvest this graft are the hamstrings, the patellar tendon, and the quadriceps tendon. Although the hamstrings tendon is the most commonly used, several studies have suggested that it might have a higher failure rate in high demand athletes. New research published at AOSSM demonstrated a significantly higher re-tear rate using hamstring tendons compared to the gold standard (patellar tendon). Read more here…

Although there are many factors that determine the best graft choice for an individual patient, it is becoming increasingly clear that hamstring grafts are probably not the best options for most young, active athletes – especially female athletes. Female athletes are at the highest risk for tearing their ACL, and having a re-tear or tear of the other side later on. We recommend using patellar tendon (bone-patellar tendon-bone, or BTB) or quadriceps tendon grafts in most young, high demand athletes. We published a research paper demonstrating that if hamstrings are used, they often need to be augmented with extra tendon from a cadaver. You can read more about female ACL injuries in a book chapter we wrote about that topic.

Get In Touch