For surgeries that require reconstruction due to damaged ligaments, tendon, cartilage or bone, your surgeon may choose to use a nonvital ligament, tendon, cartilage or bone from a surrounding area or another part of your body. Platelet-rich plasma (PRP) and bone marrow concentrate (BMC) are considered autografts, as they are derived from the patient’s own body. Other examples of surgeries that use autografts are listed here::
Anterior/posterior cruciate ligament (ACL/PCL) reconstruction for knee instability – Semitendinosus and/or gracilis tendon (ie, hamstring), patella tendon with bone, quadriceps tendon
Latarjet for shoulder instability – Coracoid bone, iliac crest bone (ie, pelvic bone)
Ulnar Collateral Ligament Reconstruction/Little League Elbow/Tommy John Surgery for elbow instability – Palmaris longus tendon, gracilis tendon
Glenohumeral (Shoulder) Dislocation
A shoulder dislocation occurs when the humeral head (ball) no longer sits on the glenoid (socket). An incomplete or partial dislocation occurs when the ball comes part of the way out of the socket and then returns without intervention. The ball can be disassociated from the socket in the front or back of the shoulder.
Ulnar Collateral Ligament Tear (UCL Tear/Tommy John Elbow)
The UCL, also known as the medial collateral or 'Tommy John' ligament, helps to stabilize the elbow joint. It does so by connecting the ulna (forearm bone) to the humerus (upper arm bone). When this ligament is stretched or injured, the bones of the elbow may separate during intense activities such as throwing.
Autograft OATS Procedure
When a cartilage lesion is small, but deep enough to include underlying bone, your surgeon may opt to obtain a piece of your own (autograft) cartilage along with a piece of attached bone from a surrounding area.
In a minimally invasive autograft OATS (Osteochondral Autograft Transfer System) procedure, the damaged cartilage is replaced by healthy cartilage and bone graft. Over time, the autograft cartilage and bone incorporates into the affected area helping to restore function, minimize pain and slow the progression of degeneration of surrounding cartilage.
Anterior Cruciate Ligament (ACL) Tear
The ACL is the main stabilizing ligament on the inside of the knee. Its main function is to prevent the tibia (shin bone) from sliding forward and rotating on the femur (thigh bone). Tears/ruptures of the ACL result in knee instability.
ACL tears are typically caused by twisting or hyperextension injuries. Sports activity like pivoting or sudden deceleration when running and falls during skiing are considered non-contact causes of ACL tears. Direct trauma to the back or side of the knee during collision sports is considered a contact injury to the ACL.
Operative management of ACL tears depends on the type of tear. ACL repair may be indicated in patients where the ACL is clearly torn off the wall of the femur (thigh bone) or tibia (shin bone. ACL repair is accomplished through a minimally-invasive arthroscopic procedure and sewed back into place and fixed with screws or buttons. The repair may also be supplemented with high-strength suture. If formal reconstruction is required, a new ACL graft will be fixed in place of the original ligament. A technique for graft placement and graft choice is a shared decision between you and your surgeon. Most techniques are performed through a minimally-invasive arthroscopic procedure. The graft can be taken from around your knee or from a donor. Postoperative rehabilitation, return to daily activities and return to sport depends on the technique and graft chosen, and is at your surgeon’s discretion.