Editorial Commentary: Anterior Cruciate Ligament Graft Selection Is Best Tailored to Individual Patient Sport and Activity Level

Abstract

Anterior cruciate ligament (ACL) reconstruction graft choice is a topic of ongoing debate. Literature shows allografts should be avoided in younger patients, and given this result, there has been a general trend toward increased use of autograft reconstruction in recent years, regardless of age. Almost concurrently, there has been an increased trend toward the use of quadriceps tendon as a primary or revision graft. In addition to these trends, more and more patients are remaining active at later ages, resulting in increased numbers of patients requiring ACL surgery at age 50 years and older. In this population, recent research shows equal outcomes with hamstring tendon and quadriceps tendon autografts, and lower return to skiing with hamstring grafts, indicating that graft choice should be tailored to the individual patient and their sport or activity level. Allografts (and any graft choice) may also show good outcomes in this age group.