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Patellar Tendon or Hamstring?Unfortunately not only will the ACL not heal on its own, sewing the ACL onlyseems to work about 65% of the time. Replacing the ACL works 98% of the time. Therefore the most common surgical procedure on the ACL is replacement or “reconstruction”. Dr. Steadman has also recently popularized a successfulmodification of the repair called “The ACL Healing Response”. Our options forreplacing the ACL include a cadaver graft, your own patellar tendon orhamstrings. All are very strong, in fact stronger than a native ACL in most circumstances. To replace the ACL we must make tunnels in the bone to place the new graft. The patellar tendon graft has bone plugs on either end and has the advantage ofbone-to-bone healing. which typically occurs in 4 weeks. The hamstring graft isall soft tissue and takes 8-12 weeks to incorporate into the bony tunnels. Both grafts will go through a process of weakening followed by revascularization and won’t achieve its maximal strength until about 9 months after surgery.Patellar Tendon graft with a Bone Plug on Either End: For the young, high level athlete we tend to favor the Patellar Tendon Reconstruction due to the lower re-rupture rate we have found. In the high-levelrecreational athlete who needs to get back to work as soon as possible, we would often favor the Hamstring Reconstruction. Both graft choices are extremely strong and work exceptionally well with the proper rehabilitation.
