Types of ACL (Grafts) Surgery

Tearing the Anterior Cruciate Ligament (ACL) is a very common injury for athletes and active individuals globally. If you have just had an ACL injury, ACL reconstruction surgery can often be the necessary step to return to optimal mobility, strength and sports. The critical decision, however, is determining the best graft type for your ACL reconstruction surgery. We'll explore the different graft options. However, the key decision making will be made with your orthopaedic consultant following a review.

What Is an ACL Graft?

During ACL reconstruction, your surgeon replaces the damaged ligament with a new piece of tissue called a graft. This graft acts as a scaffold — over time, your body grows new tissue around it, restoring knee stability and strength. The graft can come from your own body, a donor, or even synthetic material.

The Main Types of ACL Surgery Grafts

• Autograft (Your Own Tissue)

  Autografts are taken from your own body. Usually the most common choice.

  • Patellar Tendon - A part of the patellar tendon, often with a piece of bone from the kneecap and shinbone.

  • Hamstring Tendon - Tendons from part of the back of the thigh.

  • Quadriceps Tendon - Tendons from part of the front of the thigh.

  • Peroneus Longus Tendon - The peroneus longus tendon is located in the lateral (outer) side of the lower leg and ankle.

• Allograft (Donor Tissue)

  Allografts come from a human donor (cadaver). The tissue is sterilised and processed before surgery.

  Types - Hamstring, Patella, Tibialis Tendon (Anterior/Posterior), Achilles Tendon, Peroneus Longus.

• Synthetic Graft (Artificial Material)

  Synthetic grafts, like LARS (Ligament Advanced Reinforcement System), are made from high-strength fibers.

  • Achilles Tendon

  • Patellar Tendon

  • Tibialis Anterior/Posterior

  • Hamstring Tendons

Choosing the Right Graft for You?

Your orthopaedic surgeon will help tailor the choice to your lifestyle and long-term goals.

For example:

• Elite athletes often prefer patellar tendon autografts for strength and durability.

• Recreational athletes or younger patients may choose hamstring autografts for less knee pain.

• Older or less active patients may do well with allografts for quicker recovery and minimal discomfort.

The optimal ACL graft depends on several factors:

• Age and activity level

• Type of sport, hobby or occupation

• History of previous surgeries

• Personal recovery goals