Editorial Commentary: Different Grafts, Different Problems: Why Anterior Cruciate Ligament Graft Selection Requires Individualized Decision-Making

Anterior cruciate ligament graft selection requires an individualized approach and shared decision-making based on age, activity level, and numerous other patient- and knee-specific factors. Advantages and disadvantages exist with all graft types. Clinically, many studies have shown similar patient-reported outcomes, return-to-sport, and graft failure rates when comparing bone-patellar tendon-bone and quadriceps tendon grafts. Recently, there has been emerging evidence that quadriceps tendon autografts may offer a donor-site morbidity advantage over bone-patellar tendon-bone grafts while maintaining comparable clinical outcomes. However, the literature has been filled with inconsistencies on how donor-site morbidity is reported. Therefore, further research that explores donor-site morbidity for different graft types using a standardized tool could significantly contribute to optimal graft selection.