Which ACL Graft is Best? A Guide for Athletes
f you’ve torn your ACL (anterior cruciate ligament), you’re probably wondering: Which ACL graft is best? Whether you’re a pro athlete or someone who just loves playing sports on the weekend, picking the right graft is a big deal.
It can really influence how well and how quickly you recover. In this guide, I’ll walk you through the different ACL graft options, share the pros and cons of each, and help you figure out what might suit you best. But remember—there’s no one-size-fits-all answer. The best graft for you depends on your sport, lifestyle, and personal goals.
What is an ACL Graft?
An ACL graft is basically a piece of tissue used to replace your torn ligament during surgery. Surgeons usually go for one of these options:
Patellar Tendon Graft (Bone-Patellar Tendon-Bone)
Hamstring Tendon Graft
Quadriceps Tendon Graft
Allograft (Donor Tissue)
Let’s break down each option to see what’s what.
1. Patellar Tendon Graft (Bone-Patellar Tendon-Bone)
This graft uses a strip from your own patellar tendon, along with bits of bone from your kneecap and shinbone. It’s often called the "gold standard" for ACL surgeries, especially for athletes.
Pros:
Super strong and gives great knee stability.
Bone-to-bone healing can sometimes mean a faster recovery.
Cons:
Can cause pain at the front of your knee, especially when kneeling.
Might make your kneecap feel stiff or uncomfortable.
Best For: Athletes in high-impact sports like football, rugby, or basketball who need that extra knee strength.
2. Hamstring Tendon Graft
This one uses tendons from your hamstring muscles, usually the semitendinosus and gracilis. It’s a popular pick for both professional and casual athletes.
Pros:
Less pain at the front of your knee compared to the patellar graft.
Smaller incision means less scarring.
Cons:
Healing can take a bit longer since it’s tendon-to-bone.
You might notice some hamstring weakness after surgery.
Best For: Athletes in sports like running, cycling, or skiing where kneeling isn’t a big part of the game.
3. Quadriceps Tendon Graft
This option takes a piece of the quadriceps tendon from above your kneecap. It’s becoming more common, especially for people who’ve had ACL surgery before.
Pros:
Bigger, stronger graft that offers great stability.
Less chance of hamstring weakness.
Cons:
You might experience some quadriceps weakness after surgery.
Could cause more pain at the donor site than hamstring grafts.
Best For: Athletes who’ve had ACL surgery before or those in sports that rely heavily on quad strength, like weightlifting or sprinting.
4. Allograft (Donor Tissue)
An allograft uses tissue from a donor (yes, from a cadaver). While it’s not as common for younger, highly active athletes, it’s still a solid option for some.
Pros:
No need to take tissue from your own body, which means less surgical pain.
Shorter surgery time and faster recovery early on.
Cons:
Slightly higher risk of graft failure, especially in young, active people.
Very small risk of disease transmission, though it’s rare.
Best For: Older athletes or those with lower activity levels who want a quicker recovery and less discomfort.
Things to Think About When Choosing an ACL Graft
When deciding which ACL graft is best for you, here are some key things to keep in mind:
Your Sport: High-impact sports might need a stronger graft like the patellar tendon, while lower-impact activities could be better suited to a hamstring graft.
Past Injuries: If you’ve had ACL surgery before, your surgeon might suggest a different graft, like the quadriceps tendon.
Recovery Goals: Are you aiming for the quickest recovery, or do you care more about long-term stability?
Pain Tolerance: Some grafts come with more post-surgery discomfort. Think about what you’re comfortable dealing with.
So, Which ACL Graft is Best?
Here’s the thing—there’s no one "best" graft. Each option has its own perks and drawbacks, and what works for one person might not be right for someone else. The smartest move is to chat with a sports injury specialist who gets what you need and can guide you based on your goals.
At CJ Performance Healthcare, we specialise in ACL rehab and recovery, helping athletes all over Liverpool get back to doing what they love. Whether you’re a pro or just someone who enjoys a good weekend hike, we’re here to support you every step of the way.
Still unsure which graft is right for you? Book a free care call with our ACL rehab experts in Liverpool. We’ll help you figure out the best option for your situation and create a personalised recovery plan to get you back in the game.
Ready to get started? Book your free care call today!