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Regardless of whether a quadriceps tendon, hamstring tendon or donated tendon is used for the graft, a knee in which the ACL has been reconstructed twice can suffer long-term effects.

“Your best chance of the best results, if you have to have an ACL, is always the first one, not necessarily the second one,” Carr said.

“I would tell you I think there would always be a difference on that knee. The players he plays with and the players he plays against may not notice that, but you as a physician and trainer in examining that athlete will always sort of say, ‘Wow, it’s a little different than what it was.’”