Hamstring autografts may be better than patellar tendon autograftsBMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7548.0 (Published 27 April 2006) Cite this as: BMJ 2006;332:0
All rapid responses
In 1993 my left ACL was reconstructed using a patellar tendon
autograft following a skiing injury the previous year. In January 2006 my
right ACL was reconstructed using a hamstring autograft, subsequent to a
sporting injury some years earlier.
I delayed the second repair for several years because of my
experience first time round. Some 13 years on, although I have full
extension and flexion in my left knee, I am largely unable to kneel on it
due to intense pain and discomfort.
Prior to approaching my GP for a referral for the right knee
operation, I thoroughly researched the alternatives, and made the
conscious decision to choose a surgeon who specialised in the hamstring
procedure. So far it has been the right decision. After only 4 months I
can kneel on it, and strength and movement are returning at a satisfactory
The key I would like to echo from this article is the note the
authors make about the procedure being dependent on the surgeon that the
patient is first referred to. This is absolutely my experience, and
knowing what I know now I believe it is not acceptable.
The anterior knee pain caused by the patellar tendon autograft and
associated with kneeling, or even brushing the knee on the seat in front
on a bus or airplane, is intense. If I had been fully informed first time
around I would have chosen the hamstring autograft. There is clearly a
change in practice in terms of patient empowerment during the referral
process that needs to happen urgently.
Competing interests: No competing interests