Graft Options

As I mentioned there are quite a few things to think about when it comes time for ACL Reconstructive surgery. One pretty large decision you have to make is which type of graft you would like to use for your new ACL. There are 2 initial classifications – an autograft (your own body) vs. allograft (cadaver).


  1. Patellar tendon: A piece of your knee cap (bone) is taken with the tendon still attached – on the other end a piece of your tibia is taken with the same tendon attached. This is the “gold standard” when it comes to ACL reconstruction. This method however leads to a largely increased risk of tendinitis of the knee. This risk kept me away from using this method.
  2. Hamstring: A piece of your hamstring is taken to be used as the new ACL. Everything you read references that the hamstring is not as strong as your original ACL, although there are methods which increase this strength. I passed on this type of graft b/c I didn’t want to take a chunk of my hamstring, and I’m a little paranoid about the strength of the new ACL (I don’t want to go through surgery again!)


  1. Patellar tendon
  2. Hamstring
  3. Achilles tendon: I went with the achilles tendon for 2 reasons. 1. The achilles is incredibly strong (feel how tight it is!) and 2. My surgeon just so happened to have a really good graft lined up from a 24 yr old. (Crazy that they share that information, huh?)

There is a lot of conflicting information regarding what type of graft to use. For every good article you read, you’ll read another that is completely opposite. At the end of the day you need to find a surgeon who you trust — and you can always get multiple opinions.

Most every surgeon and physical therapist will tell you that the most important part ends up being physical therapy, rather than the graft itself. No matter how strong your graft is, if you don’t work hard at PT, you’re bound to have another failure.