Related Information The ACL will not heal itself and it is not currently possible to repair a torn one. Therefore, an alternative tissue must be used to replace it. There are 3 main types of grafts available: Using the patient's own tissues (autograft) Using another person's tissue (allograft) Using artificial material Using the patient's own tissue is by far the preferred way. However there may be times when this is not possible and this would be clearly explained if necessary. The two choices for graft tissue are: Hamstring tendon graft (the gracilis and semitendinosus tendons) Kneecap (patella) tendon graft The hamstring tendon graft is usually the preferred graft choice for a number of reasons. It does not disrupt the mechanism by which the knee is straightened. It has been shown to result in less post-operative pain over the front of the knee, less discomfort when kneeling post-operatively and a reduced loss of full extension (straightening) of your knee. The hamstring graft also more closely reproduces the forces of an intact ACL. The hamstring tendons used can be felt on the inner aspect of the thigh at the back of the knee. You will manage perfectly well without them and in fact research now shows that they grow back to some extent. Surgery to reconstruct the ACL is carried out via an arthroscopy and a small incision on the inner aspect of your lower leg just below your knee. The arthroscope allows additional surgery (i.e. trimming of meniscal ("cartilage") tears) to be performed at the same time Most ACL reconstructions are performed under general anaesthetic although the procedure can be undertaken under "local" or "regional" anaesthesia. In most patients the knee is not put into plaster or braced at any time after surgery.