The choice between bone-tendon-bone patellar tendon allograft or autograft

I met with my surgeon today and they are giving me the choice between bone-tendon-bone patellar tendon allograft or autograft.
I’ve read a few studies on the benefits of BTB autograft VS hamstring graft (my first reconstruction was HS and it failed after a year and a half).
The only thing the surgeon really said was that autograft would be more painful…any one have any advice on auto VS allografts?

To be clear- they are offering you BTBP Autograft or allograft. They offer the BTBP In both forms.

exactly they are offering BTBP in both allograft and autograft and I just need to decide if I want my own tissue or donor tissue

I had both BTB autograft and allograft. First, I had autograft because that is the gold standard and I never ever wanted to do this again. Unbelievably, my autograft failed—it didn’t tear, it failed to take. My surgeon was in denial because this never, ever happens. A year after autograft, I had the same surgeon do an allograft BTB. I was depressed and sure it would fail as well but I’m here to say that 2 years PO allograft, I’m all good! Autograft hurt like heck—I was on prescription painkillers for weeks but I didn’t even take OTC stuff for allograft. Whatever you pick, I wish you an amazing recovery!

Thanks Jamie! I have had HS autograft, achilles tendon allograft and both failed so I’m nervous about it.

you’ve definitely had a run of bad luck and my heart truly goes out to you.

The one thing I can say as someone who’s had BTBP Autograft is- yes it’s the “gold standard” but don’t overlook donor site morbidity, patellar tendinitis, and the higher likelihood of difficulty kneeling on your knee. Study after study confirms this. Not every patient experiences it, but more often than not you’ll see people on here posting of similar complaints post BTBP autograft.

Yeah I read that tendonitis an osteoarthritis is increased compared to others, but I already have some arthritis… its a scary choose your own adventure to choose between the two. The surgeon said they were happy to do either but need to know soon for scheduling

yeah. Based off your hx I can see the challenging decision. I’d be partial to allograft.

i haven’t had a donor graft however i have had the patella graft over 2 years ago now (it failed after about 18m). All i’d say is the front of my knee was always extremely sore and still is due to the enormous scar you get from that graft. i could kneel after about a year on a hard surface but it was not comfortable at all and only at a particular angle. my surgeon this time offered a HS or donor graft and he did inform me the donor drafts have a higher rerupture rate

I’ve had both knees done with my own patellar tendons. One was a year ago and the other was 14 years ago. Both are holding strong and on the most recent knee, the site of the graft tissue is still a bit tender and if I put pressure on it it’s uncomfortable. The other knee is almost unnoticeable. It does heal. Just my experience but I thought I’d throw it out there so you can hear a positive experience where it did work. It did hurt a lot right after surgery though