ACLR, Which Graft is Best?
ℹ️ℹ️
INTRODUCTION
Anterior cruciate ligament (ACL) reconstruction is one of the most common orthopedic surgeries in the world for active individuals.
ℹ️
The type of graft used is an important decision for ACL reconstructions.
ℹ️
Despite extensive research on the best graft choice, discrepancy still exists among, hamstring, patellar tendon and quad tendon grafts.
ℹ️
Xerogeanes (2019), makes an argument the quad tendon is the best graft choice.
📊
Recently, Quad tendon grafts have has gained popularity.
📊
The ‘all soft tissue’ quadriceps graft offers many advantages over other autograft choices. .
📊
There are 20% more collagen fibrils per cross-sectional area than the patellar tendon (PT). .
📊
Biomechanically, its ultimate load is 70% > than similar width PT grafts.
📊
Also, it’s modulus is more similar to the native ACL than either PT or hamstring grafts.
📊
Anatomically the quadriceps tendon has significantly more volume than the PT. .
📊
Following harvest, the quadriceps tendon is still 80% stronger than the intact PT.
📊
The length and cross-sectional area of the quadriceps tendon graft can be tailored to the needs of the patient. .
📊
On any patient over 5 feet tall, a graft length of 7 cm can be obtained. .
📊
Commonly Quad graft thickness is almost 2x thicker than the same patients PT, making it easy to harvest a graft diameter from 7 to 11 mm.
📊
Thus, this graft can be customized for both primary and revision surgeries.
📊
Harvest site morbidity is minimal. .
📊
An incision less than 2 cm in an area with no significant cutaneous nerves without harvest of any patella bone leads to no significant harvest site pain, numbness, or palpable defect.
📊
Clinical outcomes using this graft are excellent. .
📊
The prospective data on nearly 1,000 quad grafts, with a mean patient age being 20 years old, show a 4.2% failure rate. .
✅✅
IMPLICATIONS:
Xerogeanes (2019), argues soft tissue quadriceps graft will be the surgical choice for ACL reconstruction for future athletes.
🧠🧠🧠🧠
ℹ️ℹ️
INTRODUCTION
Anterior cruciate ligament (ACL) reconstruction is one of the most common orthopedic surgeries in the world for active individuals.
ℹ️
The type of graft used is an important decision for ACL reconstructions.
ℹ️
Despite extensive research on the best graft choice, discrepancy still exists among, hamstring, patellar tendon and quad tendon grafts.
ℹ️
Xerogeanes (2019), makes an argument the quad tendon is the best graft choice.
📊
Recently, Quad tendon grafts have has gained popularity.
📊
The ‘all soft tissue’ quadriceps graft offers many advantages over other autograft choices. .
📊
There are 20% more collagen fibrils per cross-sectional area than the patellar tendon (PT). .
📊
Biomechanically, its ultimate load is 70% > than similar width PT grafts.
📊
Also, it’s modulus is more similar to the native ACL than either PT or hamstring grafts.
📊
Anatomically the quadriceps tendon has significantly more volume than the PT. .
📊
Following harvest, the quadriceps tendon is still 80% stronger than the intact PT.
📊
The length and cross-sectional area of the quadriceps tendon graft can be tailored to the needs of the patient. .
📊
On any patient over 5 feet tall, a graft length of 7 cm can be obtained. .
📊
Commonly Quad graft thickness is almost 2x thicker than the same patients PT, making it easy to harvest a graft diameter from 7 to 11 mm.
📊
Thus, this graft can be customized for both primary and revision surgeries.
📊
Harvest site morbidity is minimal. .
📊
An incision less than 2 cm in an area with no significant cutaneous nerves without harvest of any patella bone leads to no significant harvest site pain, numbness, or palpable defect.
📊
Clinical outcomes using this graft are excellent. .
📊
The prospective data on nearly 1,000 quad grafts, with a mean patient age being 20 years old, show a 4.2% failure rate. .
✅✅
IMPLICATIONS:
Xerogeanes (2019), argues soft tissue quadriceps graft will be the surgical choice for ACL reconstruction for future athletes.
🧠🧠🧠🧠
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