Anterior cruciate ligament reconstruction in the modern era: A patient-centered approach

Table 1 Comparison of anterior cruciate ligament graft options: Patient profiles, benefits, and limitations

Graft type	Ideal patient profile	Advantages	Limitations
Bone–patellar tendon–bone	High-demand athletes; patients needing strong fixation	Bone-to-bone healing; lower graft failure rates; time-tested	Anterior knee pain; risk of patellar fracture; extensor mechanism dysfunction
Hamstring tendon	Patients prioritizing lower donor-site morbidity	Less anterior knee pain; easy harvest; good cosmesis	Possible increased laxity; slower graft integration; hamstring weakness
Quadriceps tendon	Revision cases; patients with previous graft issues	Customizable size; reduced harvest site pain; strong biomechanical properties	Less studied long-term; potential for quadriceps weakness
Allograft	Low-demand, older patients; revision or multiple ligament injuries	Shorter operative time; no donor-site morbidity	Higher failure rates in young athletes; delayed incorporation