ACL Tears – Autografts vs. Allografts

Tears of the anterior cruciate ligament of the knee are devastating injuries and, unfortunately, are on the rise in incidence. There are many factors to explain this but the increase is primarily among female athletes.
The treatment of a torn ACL is surgical in young patients and in older athletes who do not want to stop competing and enjoying sports.
Two recent events have occurred which verifies that the surgical procedures done by the surgeons at The Los Angeles Orthopaedic Institute are the BEST to reconstruct the ACL.
Two long term studies have just verified that allografts are inferior compared to autografts to reconstruct a torn ACL. Allografts are tissue from a cadaver (dead body) and an autograft is from the patients’ own body. The advantages of an allograft are smaller incisions and less pain in the first week post-operatively. The disadvantage, however, is a higher FAILURE rate which is unacceptable.
We have always known that autografts are superior and we have ALWAYS recommended autografts to our athletes!
The choice of autografts is either the patients’ patellar tendon or the hamstrings. We have always preferred the patellar tendon for THREE main reasons.
#1 – The patellar tendon has bone on either side and we get bone to bone healing which is the quickest and strongest graft!
#2 –  The patellar tendon is the strongest graft!
#3 –  We do not want to sacrifice the hamstring tendons as this leads to knee weakness and stress on the reconstructed knee.
Adrian Peterson, the elite running back for the Minnesota Vikings just returned from ACL surgery and had his best running year ever. Of course he had a patellar tendon autograft which is what we have been performing in our patients over the past twenty years.
The Los Angeles Orthopaedic Institute surgeons are the orthopaedic surgeons for Calstate Northridge (CSUN) which are the only Level I Scholarship Athletes in all of the San Fernando, Santa Clarita and Antelope Valleys. The most elite athletes, coaches and trainers have selected us to perform these surgeries on their athletes for over 15 years!
We hope you maintain healthy knees but if you or a friend tears the ACL we should be your FIRST CHOICE!

Stay Healthy,
Dr. Sisto

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New ACL Technique

The anterior cruciate ligament (ACL) is the prime stabilizer of the knee to prevent anterior instability. Ligaments are the “ropes” of the knee which connect bone-to-bone and stabilize the knee. When ligaments tear the two ends spring apart like a “torn guitarstring” and the ligament loses its blood supply and it dissolves. The patient will have an unstable knee without an ACL which can lead to a meniscus tear and early degenerative arthritis of the knee.
The reconstruction of an ACL tear utilizing the patients own tendons  (structures which connect muscle to bone) or a allograft (cadaver donor) is a successful procedure but one that, unfortunately, does not prevent and may accelerate the development of early degenerative arthritis. The reason for this is that in the past we have used a Trans-Tibial technique to perform our drill holes in the bone to stabilize the ligament. This technique cannot put the ACL graft back to its “Anatomic Footprint Position” and will change the function (kinematics) of the knee which will lead to early arthritis.
A new technique has been devised to create our bone tunnels in the femur and tibia at the “Anatomic Footprint Position” which enhances stability and restores the normal kinematics of the knee and prevents the development of early arthritis.
We routinely use this new “Anatomic” ACL reconstruction and our results have been fantastic! If you have an ACL tear, ask your surgeon if they use the new “Anatomic reconstruction technique” and if they do not, get a second opinion with us to discuss the new technique and how it will improve the long-term outcome of you surgical result!

Keep moving!
Dr. Sisto