This cadaveric biomechanical study tested nine graft tissues used in knee ligament reconstruction — harvested from young adult donors to eliminate age-related degradation — under high-strain-rate failure loading, comparing their strength and stiffness to native ACL from the same donor population.
When selecting an ACL graft, bone-patellar tendon-bone is the only single-strand option that exceeds native ACL strength at implantation; hamstring tendons provide adequate but submaximal strength with well-matched stiffness, while retinacular and narrow fascial grafts carry unacceptably high failure risk — and every graft will weaken further during the remodeling phase, so initial strength reserve matters.
This cadaveric biomechanical study tested nine graft tissues used in knee ligament reconstruction — harvested from young adult donors to eliminate age-related degradation — under high-strain-rate failure loading, comparing their strength and stiffness to native ACL from the same donor population.
When selecting an ACL graft, bone-patellar tendon-bone is the only single-strand option that exceeds native ACL strength at implantation; hamstring tendons provide adequate but submaximal strength with well-matched stiffness, while retinacular and narrow fascial grafts carry unacceptably high failure risk — and every graft will weaken further during the remodeling phase, so initial strength reserve matters.