2024 AANA/ISAKOS Specialty Day All-Access Pass-30-Year-Old Female With 15 Degree Hyperextension With an ACL Tear With Medial Meniscus Peripheral Longitudinal 10 mm Tear. What Graft Would I Use: Discussion & Voting

30-Year-Old Female With 15 Degree Hyperextension With an ACL Tear With Medial Meniscus Peripheral Longitudinal 10 mm Tear. What Graft Would I Use: Discussion & Voting

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Video Summary

The discussion covers ACL reconstruction techniques, emphasizing graft choices and augmentation. Evidence suggests that adding a lateral extra-articular tenodesis (LAT) better protects hamstring grafts in hyperextended knees, though it's less critical with bone-patellar tendon-bone (BTB) grafts unless the patient is a high-level athlete. Surgeons fix graft tension near full knee extension (zero degrees) and prioritize preventing flexion contractures during rehab, cautiously allowing hyperextension over months. Notchplasty is rarely needed if graft placement is precise. Allografts are generally reserved for older or less active patients, with autografts favored under age 30-40. Patient-specific factors guide graft and rehab choices.

Keywords

ACL reconstruction

graft choices

lateral extra-articular tenodesis

knee hyperextension

rehabilitation protocols