Sports Injury Info

Question - Hamstring Autograft Strength

by Kyle
(North East, England)

Me

Me

I've read many different articles about the strength difference between the original ACL, the patellar tendon autograft and the hamstring autograft.

Some say the patellar tendon is the gold standard because it is the strongest, whereas others say the hamstring autograft is twice as strong as the original acl and 1.3 times (or something) as strong as the patellar tendon.

I don't know what to believe. I recently read an article referring to the capability of withstanding force measured in newtons and it said

"Recalling that a normal ACL fails under a load of 1725 Newtons and a patellar-tendon replacement gives up the ghost at about 2900 Newtons, you will be appalled to learn that a semitendinosis graft substitute for the ACL falls apart at just 1200 Newtons, and the gracilis goes to pieces at a paltry load of only 860 Newtons".

So does this mean that if the tendon is reconstructed from the hamstring and gracilis it would have the tensile strength of 1200 (hamstring) plus 860 (gracilis) equaling 2060N and therefore stronger than the original ACL?

What is your opinion on the whole strength of grafts issue? I recently have had an ACL reconstruction and there fore am very interested.

I have created a story on this website detailing my injury.

Please reply. Thanks

Kyle

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Question - Hamstring Autograft Strength

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Jun 22, 2008
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starstarstarstarstar 		Strength vs. fixation
by: Bart - SII

There is a lot of literature out there regarding the tensile strengths of the ACL and the various types of graft tissues used. I don't know exact numbers, however, I believe that the more important issue is the way the graft is fixed into the bone tunnels during the surgery.

Ultimately, the most common reason for graft failure is not because of the strength of the graft, but the success of placing the graft in the correct position and that the graft does not migrate after surgery. My opinion is that the best graft choice is one that utilizes bone plugs on each end - so a patellar tendon allograft or autograft. The use of the bone plugs allows the graft to heal into the femur and tibia and provide excellent fixation - keeping the graft from migrating or stretching out.

When it comes to graft strength, any tissue used is able to withstand normal daily stresses - in fact the stress placed on the ACL with normal sports activities is well below the tensile limit.

I hope this makes sense - focus on your rehab and regaining your strength - if you do that and get your muscular stabilizers back on track, your graft strength should be fine.

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