The Short Graft ACL Reconstruction

The Short Graft Anterior Cruciate Ligament (ACL) reconstruction is increasing in popularity. Surgeons are making use of autograft lengths of between 6-6.5 cm for ACL reconstruction. The grafts of choice are the hamstring and quadriceps tendon autograft. The grafts are prepared with cortical fixation on both the femur and tibia ends for cortical fixation. Short tunnels or sockets are reamed instead of full bone tunnels. This helps with bone preservation and the patients have less postoperative pain; but will require special instrumentation for retrograde drilling. The benefit of this technique is improved postoperative hamstring strength with the gracilis preserved, as only the semitendinosus tendon is harvested to obtain a quadrupled ACL graft. The outcomes of short graft ACL reconstruction are comparable to established transportal ACL reconstruction techniques. However, there is a learning curve and additional implant costs involved. The familiarity with the surgical technique, understanding of optimal graft fixation and biology are all paramount to success of this surgery.