#Liverpool’s Virgil van Dijk ACL reconstruction gives opportunity to discuss graft choices. Some quick points:
* No perfect graft option. Pro & cons w/ all types.
* Individualized treatment & graft based on age, activity level/specifc sport, etc
A look at each. (1/5)
#LFC #EPL
(2/5). Autograft vs Allograft:
A. Autograft: Uses players own tendon. Lower failure rate. Risk pain/weakness at harvest site. ⬆️ Surgery time.
B: Allograft: Uses donor/cadaver tissue. Less pain after surgery. Higher failure/infection risk. Longer intergration time. ⬆️ cost.
#LFC
(3/5). Patella Tendon Graft (BPB) Autograft:
* Uses mid 1/3 of patella tendon w/ bone blocks
* Lowest failure rate
* Bone to bone healing
* Still considered by most as gold standard for young/high-level athletes
* Potential for anterior knee pain/numbness, patella fracture, etc
(4/5). Hamstring Autograft:
* Easier harvest & less post surgical pain than BPB
* Smaller incision
* Graft failure rate tends to be higher than BPB, esp younger pts
* Longer integration/biological healing
* Can have hamstring weakness/cramping
* Potential for graft stretching
(5/5). Quadriceps Tendon Autograft:
* Less commonly used
* Predictable graft size; thicker
* Small incision
* Less graft site & anterior knee pain
* Shown in recent study to have higher failure rate
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