Hamstring tenderness S/P graft for ACL repair

I have had three ACL repairs for sports injuries. My very first one was on the right and my dr harvested a hamstring graft for the repair. This was four years ago. I still have the sensation that there is a constant knot in the back of my leg and seems to go into spasms very easily. Is this normal so far postop. Is it something that I could expect would go away? I have done vigorous physical therapy to rehab my knee and yet it remains. Does anyone have any experience with this? Thanks.

[Dr Vinod]

Hello!

Hamstring muscle parts when used for anterior cruciate ligment reconstruction are called as autografts. They are made from semitendinosus tendon alone or combined with gracilis tendon. Both these muscles are not the primary hamstrings. A long piece is cut about 20-30 cm in length and after removed from both these tendons they are folded and braided together for the replacement surgery. They are attached to the femur and tibia bones.

There will be some problem with the gait in the post operative phase but I suppose you were given a brace for initial two to three weeks during healing which is important. After that you would need physiotherapy and the recovery is normally good if there are no infections and you complete your physiotherapy perfectly.

There will be some pain when you bend initially for 6 months but it should decrease completely. This method is the choice for the surgeon as it is minimally invasive when compared with other techniques and recently it has become even less invasive where you can be discharged from hospital in 2 days.
There seems to be some controversy as to how well hamstring tendon regenerates after the harvesting. Most studies suggest that the tendon can be regenerated at least partially, while still being inferior in strength to the original tendon so for this I would suggest you to follow up with your surgeon.

Take care!