Video Presented by JRF Ortho: An ACL reconstruction is a procedure performed on your knee during which your damaged ACL (or anterior cruciate ligament) is replaced with graft material, either from your own body (known as an autograft) or from a donor (known as an allograft). The ACL connects the femur to the tibia, and along with the posterior cruciate ligament, helps control rotation of the knee.

A partial or complete ACL tear is a common injury that often occurs due to sports-related trauma, or from activities that involve sudden stops and changes in direction, or forceful twisting or pivoting. A torn ACL can result in a popping sensation, rapid swelling, severe instability, intense pain, loss of range of motion, and may increase your chances of sustaining further damage like a torn meniscus.

ACL reconstruction surgery is often required to restore stability and range of motion after an ACL tear. The reconstruction technique and graft material used depend on your activity level; your surgeon will select the option that is best for you.

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Graft Preparation

A hamstring autograft is one of the strongest grafts used in an ACL reconstruction. As this technique is considered to be better to prevent anterior knee pain, it is often indicated in patients who kneel on a regular basis (such as cheerleaders, wrestlers, plumbers, and gardeners). During your reconstruction procedure, the surgeon will harvest the semitendinosus hamstring tendon, which runs across the inner side of your thigh and knee, and fold it to create a 2-strand tendon graft. The hamstring graft is reinforced with sutures. In addition, suture material is threaded through a tiny metal plate, which will anchor the graft following placement. In some cases, the surgeon may also harvest a portion of the nearby gracilis tendon to create a 4-strand tendon graft.


Your anesthesiologist will determine whether to use regional or general anesthesia. An ACL reconstruction is typically a minimally invasive procedure, during which surgical instruments and a scope are passed through two small incisions on either side of your knee joint. First, your surgeon will remove the torn ACL and clean any debris from where the ligament was attached. Using a guidewire and a special surgical drill, your surgeon will create a bone tunnel in the femur and tibia where the graft will be anchored.

After the hamstring graft is harvested and prepared, suture material is threaded through a special guidewire, which is then used to pull the graft up through the tibial and femoral tunnels. The metal plate lies flat on the bone surface, anchoring the femoral end of the graft in place. While the plate is the most common fixation method for the femoral end, some surgeons may use traditional screws. The surgeon may twist the graft before tibial fixation to mimic the rotational fibers of the native ACL. Over time, the tunnels will fill in with new bone, incorporating the graft tissue.


Complications associated with ACL reconstruction surgery include risk of infection or bleeding, pain around the kneecap, stiffness of the knee joint, and a limited range of motion. In some cases, a revision procedure is required.


An ACL reconstruction is an outpatient procedure and you will be able to return home the same day. After surgery, keep your leg elevated and apply ice to your knee; medication may be prescribed for pain relief. You may be instructed to walk with crutches or wear a knee brace to protect the graft as it heals. Exercise is critical to your recovery and progressive physical therapy will help strengthen the muscles around your knee and improve flexibility. Your ability to return to full activity depends on how well you follow your rehabilitation program.

JRF Ortho specializes in providing orthopedic surgeons with the highest viability, most widely available cartilage solutions in the industry. Our goal is to provide innovative solutions for allograft joint repair to orthopedic surgeons who specialize in helping patients regain movement and improve their quality of life; thus, JRF Ortho is redefining the standard for allograft joint repair and maximizing the gift of donation.

Our unique member relationship with AlloSource and Community Tissue Services(CTS) enables us to offer the largest selection of specialized high-viability fresh osteochondral grafts, tendons and menisci in the industry. Through innovation and a commitment to clinical results and positive outcomes, JRF Ortho is redefining the standard for allograft joint repair.

Our mission is to improve quality of life through innovative solutions for allograft joint repair.

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