Holy Grail of ACL Reconstruction Grafts

Selection of the appropriate graft for ACL (anterior cruciate ligament) reconstruction is very important. The right choice of graft will determine the success of the surgery. For professional athletes, the primary choice remains the bone patellar tendon graft. However, sometimes there are complaints of anterior knee pain. The patellar tendon bone remains the strongest graft source for ACL reconstruction. Currently, the most popular graft used is the hamstring tendon, which consists of the semitendinosus and gracillis. The small incision makes this tendon very popular in reconstructive surgery. However, it is not uncommon for the acquired hamstring tendon size to be unpredictable and sometimes too small. The quadriceps tendon is also a good tendon of choice in the ACL reconstruction surgery. Several studies have shown the results of reconstruction with a balanced force with the patellar tendon bone. The portion of bone obtained from the superior pole of the patella, allows bone-to-bone healing. Currently, several surgeons use the peroneus longus tendon as an alternative graft option in ACL reconstructive surgery. The small incision and the relatively easy process of taking the graft, make more and more surgeons interested in using it. However, the use of the peroneus tendon should be reserved in cases of multiple ligament injury or revision cases. Further studies are needed to evaluate the long-term effects on the involved ankle. In many countries, allografts can also be used for ACL reconstruction surgery. Its preparation requires strict conditions, so that the graft condition remains good when used.