Review ArticlesGraft Selection in Anterior Cruciate Ligament ReconstructionLin, Kenneth M. MD; Boyle, Caroline BS; Marom, Niv MD; Marx, Robert G. MDAuthor Information Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY Disclosure: R.G.M.: American Orthopaedic Society for Sports Medicine—Board or committee member; Demos Health-Publishing royalties, financial or material support; HSS Journal-Editorial or governing board; International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine-Board or committee member; Journal of Bone and Joint Surgery—American—Editorial or governing board; Mend-Stock or stock options; Springer-Publishing royalties, financial or material support. The remaining authors declare no conflict of interest. Reprints: Niv Marom, MD, Hospital for Special Surgery, 535 East 70th St, New York, NY 10021. Sports Medicine and Arthroscopy Review: June 2020 - Volume 28 - Issue 2 - p 41-48 doi: 10.1097/JSA.0000000000000265 Buy Metrics Abstract Surgical reconstruction of the anterior cruciate ligament (ACL) is often indicated to restore functional stability and prevent early degeneration of the knee joint, as there is little biological healing capacity of the native ACL. Although a reconstructed ACL does not fully restore the original structure or biomechanics properties of the native ACL, the graft used for reconstruction must not only have structural and mechanical properties that closely resemble those of the native ligament, it must also have minimal antigenicity and enough biological potential to incorporate into host bone. There are several considerations in graft selection: autograft versus allograft, and soft tissue grafts versus grafts with bone plugs. Commonly used grafts include bone-patella tendon-bone, hamstring, and quadriceps; among allografts, options further include tibias anterior and posterior, Achilles, an peroneal tendons. Optimal graft selection is not only dependent on graft properties, but perhaps more importantly on patient characteristics and expectations. The purpose of this review is to summarize the relevant biological, biomechancial, and clinical data regarding various graft types and to provide a basic framework for graft selection in ACL reconstruction. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.