Graft selection in surgical reconstruction of the multiple-ligament-injured knee

Nicholas G. Weiss, Lee Kaplan, Ben K. Graf

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Knowledge of the various graft options available for reconstruction of the knee with multiple ligamentous injuries is necessary for the surgeon and patient to make an informed decision. Allograft is frequently used for such reconstructions, because multiple grafts are often necessary. Allograft avoids the morbidity associated with autograft harvest, allows smaller incisions, and saves operative time. A concern with the use of allograft, however, is the small but serious risk of disease transmission, including viral and bacterial infections. Allograft is also expensive and its availability may be limited. Some patients may prefer reconstruction with autograft tissue. Bone-patellar tendon-bone autograft is strong, stiff, and allows bony fixation at both ends. Harvest complications, primarily anterior knee pain, are drawbacks to using this source. Hamstring tendon autograft harvest results in less donor-site morbidity and comparable strength to bone-patellar tendon-bone autograft when bundled. Quadriceps tendon autograft also has been used in knee reconstruction, offering a strong graft with less morbidity than bone-patellar tendon-bone autograft harvest. Quadriceps tendon harvest is technically challenging, however. Achilles tendon and anterior tibialis allografts, as well as both autograft/allograft patellar tendon, quadriceps tendon, and hamstring tendon can all be used to reconstruct the anterior cruciate ligament, posterior cruciate ligament, or collateral ligament complexes. Ultimately, the choice of graft is dependent on surgeon and patient preference, availability of graft sources, and the number of ligaments requiring reconstruction or augmentation.

Original languageEnglish
Pages (from-to)218-225
Number of pages8
JournalOperative Techniques in Sports Medicine
Volume11
Issue number3
DOIs
StatePublished - Jul 1 2003
Externally publishedYes

Fingerprint

Autografts
Ligaments
Knee
Allografts
Transplants
Patellar Ligament
Bone and Bones
Tendons
Morbidity
Posterior Cruciate Ligament
Collateral Ligaments
Achilles Tendon
Patient Preference
Multiple Trauma
Anterior Cruciate Ligament
Virus Diseases
Operative Time
Bacterial Infections
Tissue Donors
Pain

Keywords

  • Allograft
  • Anterior cruciate ligament
  • Autograft
  • Posterior cruciate ligament

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Graft selection in surgical reconstruction of the multiple-ligament-injured knee. / Weiss, Nicholas G.; Kaplan, Lee; Graf, Ben K.

In: Operative Techniques in Sports Medicine, Vol. 11, No. 3, 01.07.2003, p. 218-225.

Research output: Contribution to journalArticle

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