Abstract:[Objective] To compare of anterior cruciate ligament (ACL) reconstruction by autologous hamstring tendon (HT) with quadriceps tendon (QT).[Methods] Retrospective analysis of the clinical data of 86 patients admitted to our hospital from November 2016 to October 2019,according to the preoperative communication graft selection, they were divided into HT group and HT group, with 43 cases in each group.They underwent arthroscopic reconstruction of ACL with autologous HT and QT,and compared the perioperative period, follow-up and imaging results of the two groups.[Results] The two groups of patients successfully completed the surgery,and the difference in perioperative data was not statistically significant(P>0.05).Follow-up,Time to full weight-bearing activity was earlier in the HT group than in the QT group(P<0.05).The Lysholm score, IKDC2000 score, and test results of KT-1000 improved gradually in both groups(P<0.05).The difference in Lysholm scores and IKDC2000 scores between the two groups after surgery were not statistically significant(P>0.05).There was no statistically significant difference in the test results of KT-1000 between the two groups at 3 months after surgery(P>0.05),and the QT group was smaller than the HT group at 6, 12 and 24 months after surgery(P<0.05).Radiographically,the femoral tunnel were gradually enlarged in both groups(P<0.05),and the difference in tibial tunnel enlargement、Kellgren-Lawrence grade were not statistically significant(P>0.05).The difference in femoral tunnel enlargement between the two groups at 3, 6 and 12 months after surgery was no statistically significant(P>0.05), and femoral tunnel enlargement in the QT group was smaller than that in the HT group at 24 months after surgery(P<0.05).The differences in tibial tunnel enlargement and Kellgren-Lawrence grade between the two groups were not statistically significant(P>0.05).[Conclusion] Compared with HT for ACL reconstruction,QT was superior to HT in terms of postoperative anterior relaxation of knee joint and expansion of femoral tunnel,but the time of complete weight-bearing activity is later than HT.