Amiel et al. (1984) systematically compared the histology and biochemistry of five connective tissue structures — ACL, PCL, MCL, patellar tendon, and Achilles tendon — from six rabbits to determine whether tendons and ligaments are truly the same tissue, as surgical tradition had assumed.
When using a patellar tendon or hamstring autograft for ACL reconstruction, remember that you are implanting a biochemically foreign tissue — lower type III collagen, fewer reducible cross-links, less GAG — that must undergo ligamentization to approximate native ACL biology, which explains the prolonged remodeling phase and supports caution with early aggressive loading.
These data also undercut the assumption that any dense connective tissue can serve as a straight substitute for another.
Amiel et al. (1984) systematically compared the histology and biochemistry of five connective tissue structures — ACL, PCL, MCL, patellar tendon, and Achilles tendon — from six rabbits to determine whether tendons and ligaments are truly the same tissue, as surgical tradition had assumed.
When using a patellar tendon or hamstring autograft for ACL reconstruction, remember that you are implanting a biochemically foreign tissue — lower type III collagen, fewer reducible cross-links, less GAG — that must undergo ligamentization to approximate native ACL biology, which explains the prolonged remodeling phase and supports caution with early aggressive loading.
These data also undercut the assumption that any dense connective tissue can serve as a straight substitute for another.