The Ideal Graft for ACL Reconstruction

Is there a best choice of graft material to repair a torn anterior cruciate ligament (ACL)? This is a question doctors have asked and studied for the last 40 years. As time and technology march on, new ideas are researched and tested every year. In this review, the most recent data on the ideal graft choice is presented.

The authors say the perfect graft would meet three goals:

  • There would be no problems at the harvest site when tissue is taken for the graft.
  • The graft would "take" quickly and securely.
  • Patients would get back to normal activities after every ACL repair.

    Of course, there's no perfect graft for ACL repair. Each patient is different and must be examined and treated individually. But here's what the latest research shows is possible.

    There are three main types of grafts. There's the synthetic (manmade) graft, which isn't used much because of a high failure rate. The allograft comes from another donor. This eliminates any graft site problems for the patient. There is a risk of infection or disease. The most popular graft is the autograft. This is tissue taken from the patient's body, usually from the hamstring tendon or the patellar tendon.

    According to this review, of all the possible graft types, the bone-patellar tendon-bone graft still comes out on top. Some patients have knee pain after surgery using this type of graft, but the cause remains unknown. It could be a problem with the graft. Or it could be the result of the rehab program.



    References: Orrin H. Sherman, MD, and Michael B. Banffy, BA. Anterior Cruciate Ligament Reconstruction: Which Graft is Best? In Arthroscopy. November 2004. Vol. 20. No. 9. Pp. 974-980.

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