An ACL injury is a tear or sprain of the anterior cruciate ligament (ACL). The ACL ligament is one of the major ligaments in your knee that helps connect your thigh bone (femur) to your shinbone (tibia). An ACL injury can be very painful, inhibit movement of the joint and limit a return to normal activities.
As society, at all ages, moves to more active lifestyles and participation in recreational and youth sports increases, the incidence of ACL injuries – and the need for better repair solutions – continues to climb.
According to data from Transparency Market Research 2021, over 900,000 ACL reconstruction surgeries are expected to be performed in North America and Europe in 2023. Active women experience a higher incidence of ACL injuries than men because their biomechanics tend to put more stress on their knees.
Mainstream ACL reconstruction techniques utilize Patellar, Hamstring or Allograft (cadaver) tendon grafts as replacements for the injured tendon.
In some cases, a bone fragment (“plug”) is carved out of the kneecap and remains attached to one end of the soft tissue graft that is to be used as the replacement tendon.
The most common Patellar tendon graft procedure involves the extraction of two bone plugs, a large vertical scar and excision of the middle 1/3 of the Patellar tendon.
While Patellar and Hamstring tendon grafts currently represent the majority of the ACL reconstruction “market”, key issues continue to plague patients that undergo these surgeries.
The most common issues with Patellar and Hamstring surgeries relate to short- and long-term pain, the use of narcotics to manage pain, graft strength/ risk of failure, length of rehabilitation and aesthetics (scarring).
Allografts (cadaver) are sometimes used but are more expensive and have been shown to have a higher potential for failure.
The damaged ACL is removed.
An incision is made in the knee.
A graft and replacement ligament are harvested from the patellar region.
Published studies continue to show that the Quadriceps tendon provides significant advantages to Patellar, Hamstring and Cadaver tendons currently used in ACL reconstruction. The Quadriceps is known to regenerate over time, has higher tensile strength and has been shown to have a lower risk of failure. A sampling of relevant articles is shown below:
Quadriceps Tendon Graft for Anterior Cruciate Ligament Reconstruction: THE GRAFT OF THE FUTURE! – Arthroscopy … (arthroscopyjournal.org)
Quadriceps Tendon Autograft Versus Bone–Patellar Tendon–Bone and Hamstring Tendon Autografts for Anterior…
https://www.researchgate.net/publication/7239842_Short-Term_Recovery_After_Anterior_Cruciate_Ligamen …
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