- An AUTOGRAFT will use soft tissue from the patient
- An ALLOGRAFT will use soft tissue donated from another individual at the time of death. All allograft tissues are tested to make sure there are no communicable diseases.
Dr. Millett usually prefers to use a patient’s own tissue for the graft. The patient’s own tissue typically heals faster and reduces other known risks (disease, rejection, etc.). In patients who are older, who have had prior knee injuries, or who may not have sufficient tissue for grafting, an allograft might be a better choice.
In both grafting scenarios, the graft will be used to replace the ACL torn. A patella tendon autograft is a common choice, particularly in active patients. The patella tendon is the tendon that attaches the patella (the kneecap) to the tibia (the lower leg bone). This is a popular choice because the patellar tendon is large and strong, and bone can be taken out at each end of the tendon easily. The bone ends are then attached to the femur and tibia, allowing for strong, secure fixation and bone-to-bone healing.
There are other surgical graft options for autografts. One involves using the hamstring tendons (the semitendinosus and gracilis) and another involves using a portion of the quadriceps tendon taken from the quadriceps muscles. Dr. Millett will evaluate each patient to determine the best grafting option to use. In some instances, a cadaver graft (allograft) may be the best option to avoid additional morbidity to the knee.
There are many types of devices used to secure the graft to the bone. The graft is usually secured by screws and or buttons, the type of graft and the anatomic factors will determine the fixation technique.