Choosing an ACL graft
When ACL reconstruction is appropriate, Dr. Haber discusses graft options based on your age, sport, examination, associated injuries and goals. He generally favors a patellar tendon or quadriceps tendon autograft, both of which use your own tissue.
Patellar tendon autograft
A bone–patellar tendon–bone (BTB) graft includes a strip of tendon and a small bone block at each end. It is a well-established option for active patients and allows bone-to-bone healing at the fixation sites. Pain at the front of the knee or with kneeling is a potential trade-off.
Quadriceps tendon autograft
A quadriceps tendon graft uses tissue from the tendon above the kneecap. It is another reconstruction option. Graft size, strength recovery and discomfort where the tissue is taken are part of the discussion.
When repair may be appropriate
Dr. Haber also performs BEAR ACL repair for selected tears with suitable tissue. It is not his usual approach for most athletes requiring ACL surgery, and it should not be assumed to provide a faster return to sport.
Lateral extra-articular tenodesis (LET)
For selected patients at increased risk of another ACL injury, Dr. Haber may add LET to reconstruction. This additional procedure helps control rotational instability and may reduce graft failure risk in appropriate patients. It is not required for every ACL reconstruction.