Is ACL reconstruction done with a hamstring autograft?

A hamstring autograft is prepared from tendons near the back or inner side of your thigh, commonly the semitendinosus and sometimes another hamstring tendon. The tissue is folded and shaped, then placed where the ACL used to be and secured in the bone tunnels.

Because tissue is taken from your own leg, the operation and rehabilitation address both the reconstructed ligament and the donor area. Early hamstring weakness can affect walking, bending, and later sport drills, so strengthening is progressed rather than rushed.

Tell your surgeon about previous hamstring injuries, work that involves lifting, and sports requiring sprinting or sudden direction changes. Before surgery, learn the exercises and swelling-control routine you will use afterward. During rehabilitation, follow the prescribed progression for movement, quadriceps control, hamstring loading, balance, and running.

For more context, see [Hamstring Autograft](/materials/hamstring-autograft/) and [ACL Reconstruction](/treatments/sports-and-arthroscopic-surgery/acl-reconstruction/).

Seek prompt advice for fever, spreading redness, wound drainage, severe calf pain or swelling, chest pain, or breathlessness. During exercises, stop and contact the team if the knee becomes markedly more swollen, locks, repeatedly gives way, or develops pain that does not improve with the planned rest and adjustments.

Which hamstring tendons would you use? What temporary weakness should I expect? How will you protect the graft while hamstring strength returns? Which tests will show that I am ready to jog, change direction, and return to my sport?