Graft Choices for Anterior Cruciate Ligament Reconstruction

The question of which graft to use for anterior cruciate ligament (ACL) reconstruction continues to be debated at meetings around the world. The overall choice of grafts consists of autografts, allografts, and synthetic grafts. By far the two most commonly used grafts are central third bone-patellar tendon-bone and hamstring tendon, either semitendinosus alone or semitendinosus combined with gracilis. Seventy per cent of the 132 members of the ACL study group who responded to the recent biannual survey indicated that the patellar tendon is their graft of choice, while 25% use hamstring tendon. [1] The next most popular graft was quadriceps tendon, followed by allograft tendon. It is worth noting that there may be considerable geographic variation in the choice of graft for ACL reconstruction. Half of the returned questionnaires came from surgeons working in the USA. A survey of the Australian Knee Society indicated a more even distribution between patellar and hamstring tendons. [2]