Physical Therapy Continuing Education: History Fo The Hamstring Graft In Acl Surgery

Despite the emphasis in Physical Therapy Continuing education courses on preventing ACL injuries. The reality is we still see a lot of post surgical patients in our clinics following an ACL Reconstruction surgery.

The use of the hamstring graft has had a resurgence in popularity in recent time. We recently interviewed a prominent orthopedic surgeon to ask him about its history.

Here is what he said:

PhysicalTherapyContinuingEducation.Org:Lets dive into more about specifically ACL surgeries and hamstring grafts. Can you just give us a brief history of the hamstring graft? It seems like it kind of went through a phase of being popular, and then not so popular, and now popular again.

ACL Surgeon: Well, the original graft for ACL surgery actually was tendinous tissue. The tensor fascia lata band was used. Very soft tissue grafts were used. And the problem with that was that they were non-anatomical and there were issues with fixation.

Then the bone-patellar tendon- bone graft really developed and gained as the foremost graft in the 80s, as fixation for this was quite good, the strength of this was quite good, and really there were good techniques involved in using the arthroscope.

Hamstrings were then developed around the same time and utilized in the late 80s, early 90s, into the 90s, and gained favor as this was an alternative graft. The problem however, and some of the early research and literature was that the fixation for the hamstring or soft tissue grafts wasnt quite as good as the patellar tendon. Therefore the clinical results seemed to be behind that of the patellar tendon graft. So then it lost a bit of favor in the 90s maybe into the 2000s.

Then with the development of other fixation devices, it has made a surge back into favor and certainly is a nice alternative graft source and a nice graft for reconstruction of the ACL. It now is thought of, in terms of fixation, as similar to that of patellar tendon and really thought equally in terms of utilization as a graft in many instances. In fact, many people will consider it a better graft source for certain people.