When an ACL is torn there is a graft required to replace the original ACL tissue.
Autografts and Allografts
This graft is taken from one of the two hamstring tendons, more typically the medial head. Advantages no front of knee pain like the patellar tendon, and pain immediate post op and down the road is thought to be less. Disadvantages: the fixation of the graft is less strong as there is no bone to bone healing and a screw or button is required, this may lead to longer healing time. Also with taking part of the hamstring we need to regain that hamstring strength which is a primary supporter of the ACL.
Similar to the patellar tendon graft, however this is taken from the tendon between the kneecap (patella) and the quadricep muscles. Advantage is again having a portion of bone attached to the graft. Disadvantages again front of knee pain, also we could have a longer period of recovery to regain quad function and strength.
No definite “best” graft
Although there is no definite “best” graft, there are clear differences between the different graft choices (Shaerf et al. 2014). If ACL reconstruction is considered, the graft must be selected individually according to the patient’s age, sport- and work-specific requirements, and surgeon preferences.