I hear that question a lot. While it is an interesting and important question, the amount of attention that the actual graft type has received is out of proportion to its importance in my opinion. Regardless of graft type, the most important consideration in successful ACL surgery is the surgeon's ability to consistently place a tendon graft (which is strong enough) in the correct anatomic location, fix it securely and then carefully supervise an appropriate rehabilitation program that includes sufficient time for the graft to heal. When patients go to the Internet to try to sort out for themselves the plethora of data regarding graft types and the success of ACL surgery the other variables mentioned above are often neglected.
There are certainly pros and cons of the various graft choices. I believe it is wise to carefully consider the relative risk of complications when choosing the graft. However all of the grafts commonly used for ACL reconstruction have been proven to perform well when the operation and rehabilitation are done correctly and the patient is compliant. Therefore it seems to me most important for surgeon to be able to explain clearly and concisely why a certain graft choice is their own personal preference in any individual patient. This may have to do with the experience and training of the surgeon. Experienced ACL surgeons are commonly adept at handling multiple different graft types and may individualize based on patient age and activity level. Regardless of graft type, I believe the most important factor in deciding upon ACL surgery is finding an experienced arthroscopic ACL surgeon. Experience matters. Don't be afraid ever to ask the surgeon about his experience and his results.
