Graft Selection in ACL Reconstructive Surgery

Past, Present, and Future

Ahmad Oryan; Ali Moshiri; Abdolhamid Meimandi-Parizi


Curr Orthop Pract. 2013;24(3):321-333. 

In This Article


Intraarticular reconstruction of the ACL can be done using many types of autogenus grafts, such as combined semitendinosus gracilis hamstring tendon, bone-patellar tendon-bone composites, or quadriceps tendon.[27] However, most surgeons prefer the central third of the patellar ligament; others use one or two strands of hamstring tendon.[11] Recently, four strands were found to be superior to two strands.[2]

The advantages of autografts compared with allografts have been demonstrated.[11] For example, they are not involved in transmission of diseases, do not initiate host's immune reaction, and are inexpensive.[11] However, serious limitations have been suggested for autografts, such as limited availability, increased operative time, and adverse functional changes, including muscle weakness at the donor site and graft site morbidity, which may have a detrimental effect on the final outcome of the surgical reconstruction.[12]