The most commonly used grafts are bone-patellar tendon-bone and hamstring autografts. The
improvements in fixation devices for soft-tissue grafts have popularized the use of hamstring
autografts in recent years; many surgeons base their graft selection on minimizing harvest-site
Anterior Cruciate Ligament Substitutes â€¦ Under 40 go for Hamstrings Over Allograft BTB
The most commonly used grafts are bone-patellar tendon-bone and hamstring autografts.
The improvements in fixation devices for soft-tissue grafts have popularized the use of
hamstring autografts in recent years; many surgeons base their graft selection on minimizing
harvest-site complications. There are substantial complications in association with the use of
bone-patellar tendon-bone autograft, including anterior knee pain, pain with kneeling, loss of
extension, and poorer recovery of quadriceps strength.
The use of hamstring autograft avoids these complications but has been reported to result in
weakness of knee flexion and internal rotation, which may be crucial for certain athletes who
rely on these important hamstring functions for optimum performance.
Sensory deficits resulting from injury to branches of the saphenous nerve during hamstring
harvest have been reported. It has been well documented that the hamstring tendons
regenerate, but the function of regenerated tendons has been called into question as the
tendon often heals in a non-anatomic position. Tiger Woods had a hamstring graft substitute
A New study , presented at the American Orthopaedic Society for Sports Medicine 2008
Annual Meeting, found that because of the almost 24% failure rate, the use of cadaver
replacement ligaments might not be the best choice for young athletic patients. The older
groupâ€™s failure rate was 2.4%. So although there are obvious benefits to using the cadaver
ligament, such as avoiding a second surgical site on the patient, a quicker return to work,
and less postoperative pain, for a young patient who is very active, it may not be the right
A article in Arthroscopy in 2009â€³ compared, 156 (76 in the autograft group and 80 in the
allograft group) were available for full evaluation. Evaluations included a detailed history,
physical examination, functional knee ligament testing, KT-2000 arthrometer testing
(MEDmetric, San Diego, CA), The mean follow-up was 5.6 years for both groups.
There were no statistically significant differences according to evaluations of outcome
between the 2 groups except that patients in the allograft group had a shorter operation time
and longer fever time postoperatively compared with the autograft group.
The postoperative infection rates were 0% and 1.25% for the autograft group and allograft
group, respectively. There was a significant difference (P < .05) in the development of
osteoarthritis between the operated knee in comparison to the contralateral knee according
to radiographs.However, no significant difference was found between the 2 groups at the
final follow-up examination . CONCLUSIONS: Both groups of patients achieved almost the
same satisfactory outcomes after a mean of 5.6 years of follow-up. Allograft is a reasonable