Welcome to ACL Peer from Dr. Trong Anh

ACL graft options fall into three main categories: autografts (your own tissue), allografts (donor tissue), and less commonly, synthetic grafts, with hamstring, patellar tendon (BTB), and quadriceps tendon being the most popular autografts, each offering different benefits and drawbacks like donor site pain, surgical time, and retear rates, making the best choice highly individual.
Autografts (Your Own Tissue)

• Hamstring Tendon (HT): Most common, good strength, less donor site pain than BTB, but can have hamstring weakness.
• Bone-Patellar Tendon-Bone (BPTB): Considered gold standard, strong fixation, but potential for anterior knee pain and kneeling pain.
• Quadriceps Tendon (QT): Increasingly popular, strong, good for revision cases, often with a bone block.

Allografts (Donor Tissue)

• Sources: Achilles, patellar tendon, hamstring.
• Benefits: Shorter surgery, no donor site pain.
• Drawbacks: Longer incorporation time, higher retear risk (especially in young athletes).

Synthetic Grafts

• Examples: LARS (Ligament Augmentation and Reconstruction System).
• Use: Less common, sometimes used to reinforce other grafts (like InternalBrace).

Choosing the Right Graft

• Factors: Age, activity level, surgeon's experience, preference, risk tolerance, and specific knee needs.
• Younger Patients (<25): Often favor autografts due to lower retear risk.
• Older Patients (>40): Allografts can be a good option for quicker recovery from donor site issues.

Often, surgeons prefer 10-14 days after injury to let swelling go down and mobility return to void post-op stiffness.  

If later than 1 month, your knee will benefit from prehabilitation exercises. Research shows improved results—including for return to sport—when the following are true before ACL reconstruction surgery:

• Swelling is minimal.
• You can fully straighten your knee.
• You’ve recovered most of your normal knee bending or flexion.
• The muscles (especially the quadriceps) surrounding your knee are strong.

Yes, it is often done under general anesthesia. Sometimes, an injection to your spine (epidural anesthesia) is applied to control the pain before or after surgery.   

Full return to sports typically takes 9 to 12+ months.

As soon as possible, often within days.

Typically about 2-3 weeks, though it varies based on meniscus repair.