Hamstring VS Patella

by Gabriel
(Miami, florida)

Hello, Im Gabriel, 28 y/o Male. I love to play sports. I Play basketball, football, and practice Brazilian jiu jit su OFTEN. My question is do I get surgery using patella or hamstring? I have read MANY articles and cant get a clear answer. I understand alot of the plus and minuses but never read the ones I wanna know. Like, is a 4 strand hamstring surgery just as strong as a patella?

I really wanna get back to my active life, is one better than the other for really active people? I need help. Thx

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Hamstring VS Patella

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Dec 09, 2008
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hamstring vs. patella tendon
by: Bart - SII

This is the million dollar question when it comes to ACL reconstructions...and unfortunately, there just isn't a clear cut answer. There is research out there to support both graft types - some will say one is better than the other, however, a lot of long term follow up will depend on rehab, patient compliance, surgeon skill, and many other factors.

So, let me give you my opinion, based on the patients I have seen over the last 10 years.

By and far, the majority of my patients have been patellar tendon reconstructions. That was partially because of the surgeons that I work with and their preference. I have seen many hamstring reconstructions as well. When comparing the two, I believe that long term, the patellar tendon ACLs end up with a better outcome - a more stable knee, and less complications.

The key, in my opinion, is not necessarily the strength of the graft. When the ACL graft goes through the incorporation process, it ends up losing strength and then regaining it. The key is in the fixation. Soft tissue to bone vs. bone to bone. With the patellar tendon, you have the ability to heal bone to bone with the bone plugs. With the hamstring graft, you heal soft tissue to bone, and that doesn't produce as solid of a fixation.

In reality, with good rehabilitation and a skillful surgeon, either graft will work well. It comes down to your personal choice, and making sure you weigh all of the options before you go ahead.

Bart

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Dec 09, 2008
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Submitted by: Bart - SII

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This is the million dollar question when it comes to ACL reconstructions...and unfortunately, there just isn't a clear cut answer. There is research out there to support both graft types - some will say one is better than the other, however, a lot of long term follow up will depend on rehab, patient compliance, surgeon skill, and many other factors. So, let me give you my opinion, based on the patients I have seen over the last 10 years. By and far, the majority of my patients have been patellar tendon reconstructions. That was partially because of the surgeons that I work with and their preference. I have seen many hamstring reconstructions as well. When comparing the two, I believe that long term, the patellar tendon ACLs end up with a better outcome - a more stable knee, and less complications. The key, in my opinion, is not necessarily the strength of the graft. When the ACL graft goes through the incorporation process, it ends up losing strength and then regaining it. The key is in the fixation. Soft tissue to bone vs. bone to bone. With the patellar tendon, you have the ability to heal bone to bone with the bone plugs. With the hamstring graft, you heal soft tissue to bone, and that doesn't produce as solid of a fixation. In reality, with good rehabilitation and a skillful surgeon, either graft will work well. It comes down to your personal choice, and making sure you weigh all of the options before you go ahead. Bart

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Dec 10, 2008
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Ummmmm.
by: Gabriel

I understand what you are saying with the bone to bone healing. I have read that as well. But I have read on the contrary about long term. The stuff i read says that the hamstring procedure has less after effects than pattell. Pattella tendo people tend to suffer from kneeling pain and weaker quads. I am by no means an expert and only know what I read on the internet. Im in the ARMY and getting my surgey from a german doctor. He reccommends hamstring, but I did have an ARMY doctor who reccomended Patella. I really dont know what im gonna do. Ihave my surgey tuesday and we definatly keep you and all future visitors informed.

Jan 07, 2009
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2nd ACL op
by: adam from england

hello i ruptured my ACL and MCL just over 2 years ago 18 mornts ago i had my first reconstruction which was a hamstring graft unfortunately roughly 16 months after my op warming up for a rugby game my knee went from under me i am now waiting for my next reconstruction operation which will be the patellar reconstruction i have as im sure many others have is that alot of the information is very similar i have read almost exactly the same thoughts on each page not sure if it helps but i have been assured by my surgeon that he feels the patellar reconstruction will be best however he has warned of the knee pain and also the possibility of splitting the knee cap for extreme sports or heavy duty stuff i would go for the patellar purely because the hamstring one did not last for me hope that gives an insight

Jan 08, 2009
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Thx, but heres some more advice
by: Gabriel

HI adam, thx for trying to help but i already got my surgery and i did go with the hamstring. It hurts like hell right after surgery but its been 3 weeks and im already walking without crutches without a limp. I dont even wear a brae at all so that im constantly strengthing it. I can run or nothing like that yet but progress deffinatly seems fast. To anyone that reads this listen up. If i could do it all over again I would go with the cadaver donated ligaments. MOST the pain after operation was from the graph they took from my hamstring. You will endure far less pain witht his surgery. My BEST friend had this done and i shouldof listened to him. You will read negative things about it but thats because it the newest method out and only done in the states. The only down side is that it will take longer to get to 100% because the freezed tissue has to re vascularise in your body unlike tissue thats taken directly from your body. But take it from me, FAR LESS PAIN!

Feb 06, 2009
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Patella or Hamstring
by: Anonymous

After tearing my ACL my Doctor explained it to me in simple terms which i guess i have always followed. If i was playing Rugby or full contact sport he advised that i have a hamstring reconstruction. Reason being that it is much stronger. If i had the patella reconstruction, it gives more flexability in the knee and would help for sports such as soccer where i would be twisting and turning alot more.

Hope this helps

Tim

Mar 29, 2009
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16 yr. old female hamstring surgery
by: Anonymous

My daughter had acl and meniscus repair surgery on March 3 09. She is a bxball player who plays year round. The dr. took her sport into consid-eration before helping us make a decision. (he is also a dr to the Port. Trail Blazers and teaches these diff techniques to other drs.) Andi, my daughter, did not want to have a huge scar down the middle of her knee, and problems with pain when kneeling in the future. With the cadaver ligament, you really have no way of knowing whether you're getting a 50 or 60 year old male or female ligament, plus the healing process is much longer when you don't use you're own tissue. (plus, you really have to trust that the people doing the screening of the cadaver tissue are'nt slacking on the job)So far, so good after 4 weeks. I'm more worried about the psych part when she is able to play again in the fall. Dr. and PT's say it will be 1 and 1/2 times stronger than before.

Mar 31, 2009
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OOPS 16 yr. old...
by: Anonymous

Forgot to mention that we decided to go with the hamstring, and are happy with our decision. First 10 days were rough. They gave Andi Morphine and Percocet, which was hard on her system, and made her very constipated, and sick to her stomach. We got her off the meds asap and alternated with Ibuprophen and Tylenol. I was thinking she may only miss a week of school, but really needed two weeks off. She can't put any weight on the injured leg at all for 1 month because of meniscus repair also.
One more thing... If you get a Game-Ready Unit or ice machine(sleeve taht fits over leg) Be very careful. We used it as much as possible and ended up frost-biting her leg. It was more painful than the actual wound.