Hamstring Tendon Graft Reconstruction of the ACL

There are many different ways to do this operation. One is to take a piece of the hamstring tendon from behind the knee and use it in place of the torn ligament. When arranged into three or four strips, the hamstring graft has nearly the same strength as other available grafts used to reconstruct the ACL.

This is the method that was used on my knee!

The hamstring muscles run down the back of the thigh. Their tendons cross the knee joint and connect on each side of the tibia. The graft used in ACL reconstruction is taken from the hamstring tendon (semitendinosus) along the inside part of the thigh and knee. Surgeons also commonly include a tendon just next to the semitendinousus, called the gracilis.

The hamstrings function by pulling the leg backward and by propelling the body forward while walking or running. This movement is called hip extension. The hamstrings also bend the knees, a motion called knee flexion

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What does the surgeon hope to accomplish?
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The main goal of ACL surgery is to keep the tibia from moving too far forward under the femur bone and to get the knee functioning normally again.


There are two grafts commonly used to repair a torn ACL. One is a strip of the patellar tendon below the kneecap. The other is the hamstring tendon graft. For a long time, the patellar tendon was the preferred choice because it is easy to get to, holds well in its new location, and heals fast. One big drawback to grafting the patellar tendon is pain at the front of the knee after surgery. This can be severe enough to prevent any pressure on the knee, such as kneeling.


For this reason, a growing number of surgeons are using grafted tissue from the hamstring tendon. There are no major differences in the final results of these two methods. When it comes to symptoms after surgery, joint strength and stability, and ability to use the knee, either method is good. However, with the hamstring tendon graft, there are generally no problems kneeling and no pain in the front of the knee.