Alexander E Weber, MD
Orthopaedic surgeon & sports Medicine specialist

Autograft Options for ACL Reconstruction: Choosing the Right Path to Recovery

Jun 07, 2023
In this blog post, we will explore the various autograft options available, highlighting their pros, cons, and considerations to help you make an informed decision.

Patellar Tendon Autograft

The patellar tendon autograft involves using a portion of the patient's patellar tendon, along with bone blocks from the patella and tibia. This autograft option offers several advantages, including excellent tensile strength and predictable outcomes. However, it may cause anterior knee pain and stiffness, and there is a small risk of patellar fracture or patellar tendon rupture. This graft is often recommended for younger, high-demand athletes.

Hamstring Tendon Autograft 

The hamstring tendon autograft utilizes the gracilis and semitendinosus tendons, located at the back of the thigh. This option provides a less invasive approach compared to the patellar tendon autograft. It offers good stability, decreased donor site morbidity, and a lower risk of anterior knee pain. However, it has slightly lower initial graft strength and a slightly higher failure rate in young, highly active patients. Hamstring tendon autografts are commonly recommended for non-elite athletes and individuals with sedentary lifestyles.

Quadriceps Tendon Autograft 

The quadriceps tendon autograft involves using a portion of the quadriceps tendon, located above the patella. This option provides a robust graft with good biomechanical properties, similar to the patellar tendon autograft. It offers the advantage of avoiding patellar bone blocks, potentially reducing the risk of patellar complications. However, the quadriceps tendon autograft may lead to anterior knee pain and limited extension strength. It is often considered for patients with a higher risk of patellar complications or those with pre-existing patellar tendinopathy.


Choosing the appropriate autograft option for ACL reconstruction is crucial for successful outcomes and patient satisfaction. Each autograft choice has its advantages and considerations, depending on factors such as age, activity level, and pre-existing conditions. Consulting with an experienced orthopedic surgeon is essential to determine the most suitable option for each individual, ensuring a smooth road to recovery.

Dr. Weber and his team treat over 200 Los Angeles athletes and weekend warriors with ACL tears each year. We provide personalized treatment for all knee injuries from professional athletes to high school recreational players to weekend skiers. If you are a patient with a knee injury in Los Angeles, please reach out. We can see you within 24 hours.