The graft used in ACL reconstruction is taken from the hamstring tendon (semitendinosus) along the inside part of the thigh and knee. Their tendons cross the knee joint and connect on each side of the tibia. The hamstring muscles run down the back of the thigh. (There is one ischial tuberosity on the left and one on the right.) The top of the hamstrings connects to the ischial tuberosity, the small bony projection on the bottom of the pelvis, just below the buttocks. The hamstrings are formed by three muscles and their tendons: the semitendinosus, semimembranosus, and biceps femoris. The hamstrings make up the bulk of the muscles in back of the thigh. The ACL runs through a special notch in the femur called the intercondylar notch and attaches to a special area of the tibia called the tibial spine. The ACL is located in the center of the knee joint where it runs from the backside of the femur (thighbone) to the front of the tibia (shinbone). Ligaments are tough bands of tissue that connect the ends of bones together. Related Documents: A Patient's Guide to Anterior Cruciate Ligament Injuries Anatomy what to expect before and after the procedure.what parts of the knee are treated during surgery.When arranged into three or four strips, the hamstring graft has nearly the same strength as other available grafts used to reconstruct the ACL. One is to take a piece of the hamstring tendon from behind the knee and use it in place of the torn ligament. There are many different ways to do this operation. When the anterior cruciate ligament (ACL) in the knee is torn or injured, surgery may be needed to replace it.

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