An ACL injury is one of the most difficult injuries an athlete or active person can suffer. You usually need surgery to return to your sport or exercise. What graft you choose for the surgery can play a role in your outcome. In this Ask Dr. Geier video, I discuss graft options and one specific complication of one of the most popular graft options. Does a patellar tendon graft for ACL surgery cause knee pain?

Christina asks:
My 16-year-old daughter tore her ACL and MCL during soccer while playing the field. We have done much research and are leaning towards the patellar tendon graft. However, it was recently brought to our attention that this type of surgery is not recommended for people whose work requires them to be on their knees. Her main position for club soccer is goalkeeper. I’m wondering if this is the best option or if a different graft would be better?

There are many pros and cons to the different ACL reconstruction graft options – patellar tendon grafts, hamstring grafts and even allografts. Patellar tendon and hamstring autografts are generally good options for young athletes.

There is concern using a patellar tendon graft in someone who performs a job where he kneels a lot, such as a carpenter or mechanic. The direct pressure on that tendon can be uncomfortable. For that reason, many orthopaedic surgeons choose hamstring grafts or other options for those patients.

In this video, I discuss different graft options for ACL surgery.

Patellar tendon graft used as the ACL graft
The middle third of the patellar tendon (yellow arrow) is the graft for the ACL reconstruction in this procedure.

Also read:
Ask Dr. Geier – Graft options for ACL surgery
Ask Dr. Geier: Risk of tearing the ACL graft or the opposite knee’s ACL

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