Boston Sports Medicine and Performance Group, LLC Blog

ACL Grafts and Eggs

Posted by Boston Sports Medicine and Performance Group on Wed, Dec 8, 2010 @ 07:12 AM

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A physician friend of mine challenged me the other day about a recent post regarding omelet’s and rehab.  He thought it was a nice piece but mentioned that it may not apply to all aspects of medicine – “there are just too many variables that have to be considered” he said.

Like what? I asked him

“Take for example the common ACL reconstruction – allograft, autograft, hamstring, patellar tendon, etc.  Each graft is the central part of that surgery and thus an egg, yet each one is different” he explained.


“Those are peppers and mushrooms,” I told him.

The key to each and every ACL surgery is the tunnel angle and placement, not the graft choice.

You may choose a bone-tendon-bone graft for example after a previously failed surgery or for those athletes that play a contact sport – but you certainly wouldn’t for someone that performed physical labor like installing carpet where they spent the majority of each day on their knees would you? Graft choice is the pepper in your omelet – mind you a very big piece of this omelet, but a pepper none the less.  Perfect tunnel placement and angle on the other hand, is a must in any successful ACL reconstruction – it’s the egg in the omelet. Get it wrong and you’ll be cleaning up that sticky yellow yolk for years to come.

There are a few things that must take place in every surgery, just like in any rehabilitation and performance programming that make it a successful operation; without that key ingredient your patient will always walk, or well limp, back through your door sometime down the road.


Art Horne is the Coordinator of Care and Strength & Conditioning Coach for the Men’s Basketball Team at Northeastern University, Boston MA.  He can be reached at

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