01/14/2026
🦵 ACL Reconstruction Explained
ACL reconstruction can be performed in a variety of ways—and understanding the anatomy helps clarify the options.
The knee joint is made up of the femur, tibia, and patella (kneecap), along with the patellar tendon. The ACL is the ligament located in the center of the knee, responsible for providing stability. When it is torn and the proper indications are present, ACL reconstruction may be required.
One option for reconstruction uses the patellar tendon. This involves a small incision to harvest a portion of the patellar tendon along with a small piece of bone from above and below. The graft is then passed through the tibia to recreate the ACL and secured with screws.
Another option is using a hamstring graft. This approach typically requires a smaller incision and uses soft tissue only, without bone. While it can be an effective option, studies suggest that in approximately 35% of cases the hamstring does not fully grow back, and some data indicates a slightly higher failure rate.
Ultimately, graft choice depends on the individual case and surgeon preference. As Armin Tehrany explains, he personally prefers the patellar tendon in many situations.
At Manhattan Orthopedic Care, the focus is always on selecting the approach that best supports long-term knee stability and patient outcomes.