During anterior cruciate ligament reconstruction, the orthopedist will replace the anterior cruciate ligament through keyhole surgery.
Different tissues can be used to form the new cruciate ligament from for this purpose.
The first is hamstring plastic surgery. This uses tendons from the back of the thigh to make the new anterior cruciate ligament.
Another tissue that can be used is part of the quadriceps tendon. This involves using the middle 1/3rd of the quadriceps tendon to create a new cruciate ligament. This tendon is often seen as the first choice in young female athletes (14-25 years old). This is because it is more common in this target group that hamstring tendons are not thick enough to make a strong new cruciate ligament. Apart from the fact that the tissue is taken from a different place, the rest of the surgery is identical to hamstring plastic surgery.
A final but much less common is the bone-patella-bone plasty. This involves using tissue from the patellar tendon to make a new cruciate ligament. Two bone pieces are then also attached to either side of the tendon. An advantage of this method is that the bone pieces allow the new ligament to grow in more quickly.