Dr. Jeff Abrams
Princeton, New Jersey

Graft choices vary depending on surgical morbidity and possibly on postoperative expectations. Hamstring fixation has improved over the years, and may be more applicable to more athletes, including recreational athletes who have to go to the office on at the beginning of each week.

F. Alan Barber MD, FACS
Plano, Texas

Several graft options are available. I use the patellar tendon autograft most often. The bone plugs at both ends of this graft heal rapidly in place and permit the fastest return to full sports participation, usually between three and four months after surgery. Autografts are taken from your own body, eliminating completely any concerns about viral diseases transmission and rejection reactions. Autografts have been used for many years and are rapidly incorporated into your body.

Dr. Don Johnson
Ottawa, Canada

The choice of a graft is immaterial. The outcome of the ACL reconstruction depends not so much on the type of graft, but on the technique of placing the graft in the correct position, the fixation of the graft, and the post-op rehabilitation. Because of the minimum harvest site morbidity, the commonest graft use in our sports clinic is the hamstring graft. The patellar tendon graft is used for the athlete who wants to return to sports early, for example at 3 months. The earlier return to activities is based on the faster healing of the bone to bone healing of the patellar tendon graft compared to the tendon to bone healing with the hamstring graft. The latter may take as long as 3 months to heal.

Dr. Hugh West
Salt Lake City, Utah

For most people, I prefer to use a hamstring graft. I like this graft because the rehabilitation is much easier and because I think that the results are equivalent to patellar tendon grafts. Over the last few years, more and more surgeons have started using hamstring grafts, and around the country right now it's probably about fifty-fifty between patellar and hamstring grafts. I have acquired a lot of experience with both types of grafts over the last ten years, and I feel that the hamstring graft is much easier on my patients and that it makes it possible for them to get back to their daily activities and sports much more quickly than with other grafts.