Contemporary Graft Options in Anterior Cruciate Ligament Reconstruction

The optimal graft choice for anterior cruciate ligament (ACL) reconstruction remains controversial. Many factors must be considered to select the appropriate graft for each patient. Commonly used autografts include both hamstring tendon and bone-patellar tendon-bone, with long-term studies supporting either graft choice. There is also increasing support for quadriceps tendon autograft. The use of allograft is also increasing, with the benefit of less donor-site morbidity, although there is concern about slower graft incorporation time and disease transmission. Synthetic grafts are yet another option; however, further studies for an ideal synthetic ACL alternative are still underway. The goal of this article is to present the benefits and drawbacks of various ACL graft reconstruction choices so the surgeon can select the best graft for each patient.