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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(05): e642-e649
DOI: 10.1055/s-0044-1779335
Artigo de Atualização
Joelho

New Graft Choices for ACL Reconstruction: Update Article

Article in several languages: português | English

Authors

  • Paulo Henrique Schmidt Lara 

    1   Centro de Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil

  • João Victor Novaretti 

    1   Centro de Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil

  • Gilvan Rodrigues da Silva Nunes 

    1   Centro de Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil

  • Moises Cohen 

    2   Departamento de Ortopedia e Traumatologia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil

  • Leonardo Addêo Ramos 

    1   Centro de Traumatologia do Esporte, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Abstract

Reconstruction of the anterior cruciate ligament (ACL) is a common procedure for injuries to this ligament, especially in athletes. There are different types of grafts used, and the choice depends on several factors. Autologous grafts, from the patients themselves, are the most common option, with rapid incorporation and a lower failure rate. Allografts from donors have their role in specific cases. Synthetic grafts, used in the 1980s, have advantages such as the absence of morbidity at the donor site, but studies have shown long-term complications. Hybrid grafts, combining autologous grafts and allografts, have gained interest, allowing a larger diameter and reducing morbidity. Peroneus longus tendon autograft has received attention, with positive results, good knee function and less hypotrophy of the thigh at the donor site. Autologous quadriceps tendon graft has gained popularity, with results comparable to patellar and flexor tendon grafts, lower morbidity at the donor site and a lower rate of re-rupture. The choice of graft has evolved, with autologous flexor grafts being preferred for less active patients and patellar grafts with bone fragments for high-performance athletes. Allografts, synthetic and hybrid grafts have their role in specific circumstances. The choice must be based on scientific evidence, considering advantages and disadvantages. ACL reconstruction is a complex procedure that requires individual considerations to select the most appropriate graft.

Keywords

anterior cruciate ligament - grafting - knee

Financial Support

The authors declare that there was no financial support from public, commercial or non-profit sources.


Work carried out at the Sports Traumatology Center, Paulista School of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.




Publication History

Received: 12 July 2023

Accepted: 10 August 2023

Article published online:
23 April 2024

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