Graft Choice in Anterior Cruciate Ligament Reconstruction

Abstract

Anterior cruciate ligament (ACL) reconstruction is one of the most frequent surgical procedures performed by the sports medicine orthopedic surgeon. Many factors can influence the final outcome of the procedure, and the graft used is one of them. Over the years, the surgical technique has evolved and has been refined, including tunnel placement, graft fixation, and graft choice. For the latter, the main options available to the surgeon are autografts, which include patellar tendon, hamstring tendons, and quadriceps tendon autografts, allografts, and synthetic grafts. The ideal option for graft material, if there is one, is still to be determined. All graft options have advantages and disadvantages. Usually, the operating surgeon’s preference or recommendation will determine the graft to be used, as such it is very important to have a complete knowledge of the advantages, disadvantages, and individual needs of each patient before making a decision. This chapter will focus on graft options for ACL reconstruction, evaluating the existing literature in order to provide an up-to-date review on the subject and, hopefully, contribute to an evidence-based decision for graft choice in ACL reconstruction.