T Nation

ACL Graft Hamstring or Patellar Tendon?


#1

I'm going in for surgery on Thursday for an ACL reconstruction surgery.

I wanted to know which graft is better for a basketball player.

I've heard that the patellar tendon graft can cause permanent stiffness, but i dont want to do the hamstring one because i feel i need all my hamstring strength for vertical jumping. I asked the doctor what muscle is more important for jumping and he said the quads, but i've read and thought that the hamstrings and the posterior chain are the most important muscles for jumping.

Would removing one of these hamstring tendons cause me to lose potential jumping ability in the future?

Anyways, I had to give the doctor an answer today as to what graft to use, and i'm gonna go with the hamstring one.

Another question of mine is if leg extension is harmful during my rehab of the ACL, I sometimes feel that my school's athletic trainers are gonna put me through some harmful exercises.

Thanks to anyone who responds...

I'm a lurker and will get my pics up after my rehab is going strong.(man, my wheels were just starting to feel good, i was almost dunking too!)

Oh well, this will give me an excuse to train hard and get stronger.

Peace, laxdawg42


#2

My anatomy teacher told us the plantaris muscle in the calf (very similar to the gastroc) is often used as a replacement for the ACL. This is because it is not really needed given the force production by the gastrocs. But some people don't have a plantaris muscle so you would have to find that out if you even have one.

The knee extensors are important in jumping because the force generated by extending the knee genrates more force in plantar flexion. The posterior chain is stressed by coaches so much because that is usually a huge weak point in many athletes. Many athletes have stronger quads than hams. But the glutes are the really important PC muscle for hip extension in jumping.


#3

Most of the patients that come through our clinc post op ACL reconstruction have either had a hamstring graft or a cadaver tendon graft. Based on personal observations and research that I have looked at, generally both are relatively equal in effectiveness and failure rates. The same for patella tendon grafts, however I have had some PTs tell me that these patients tend to be more prone to tendonitis in later stages of rehab. I don't think that having a hamstring graft will affect you negatively after you have completely recovered. Typically, the only modification that we use if someone has had a hamstring graft is to delay aggressive HS strengthening a bit longer to allow the area to heal. Hope that helps some.


#4

Well, I'm not in the medical profession, but I can tell you from experience.

I had ACL reconstruction about 2yrs ago, using a patella tendon graft. At the time, my doctor told me that with cadavor grafts, you run the risk of your body rejected it. He said he only recomends that for patients over 40.

He also told me he recomeded a patella graft over a hamstring graft, but he really didn't get into specifics on why. most other doctors I spoke to said it didn't really matter either way.

As for my results, the only thing that really suffered was my jumping (I know you don't want to hear that). I went from being able to dunk with ease (not bad for a 6'2" white guy...) to barely being able to grab the rim. Everything else seems to be pretty much back.

As for rehab - leg extensions are good, but must be introduced very slowly, and stopped at the 1st sign of pain. If overdone, will almost guarentee tendonitis further down the line during rehab.
good luck - be patient. unfortunately, ACL recovery is a long process and can't be rushed. make sure you get to therapy and do all the prescribed exercises at home.

hope this helps