Number One Overall Graft Pick? Hamstring vs Bone-Patellar-Tendon-Bone vs Quadriceps Tendon

Inclusion Criteria: * \- confirmed diagnosis of a complete primary unilateral ACL rupture based on all of the following: * history of a traumatic injury episode * physical exam findings of increased anterior translation of the tibia on the femur (Lachman test and/or anterior drawer test) * positive pivot shift test * patients must be 14 to \</= 50 years (at time of surgery) * x-rays showing skeletal maturity (i.e. tibial tubercle fused) and no fractures * MRI prior to surgery (note: if the radiologist's report states an incomplete or partial ACL on MRI but the surgeon diagnoses the patient with a complete unilateral tear based on the clinical criteria above, then the patient will be considered eligible. Final eligibility will be determined intra-operatively.) Exclusion Criteria: * \- ACL rupture on contra-lateral limb * Partially torn ACL \*final determination made intra-operatively * Concomitant medial collateral, lateral collateral, or posterior collateral ligament tears requiring surgical repair \*final determination made intra-operatively * Severe chondromalacia (Grade IV on the ICRS scale) \*final determination made intra-operatively * ACL reconstruction using allograft tissue * Confirmed connective tissue disorder * Unwillingness to be followed for 24 months post-operatively * History of rheumatoid arthritis * Pregnancy (at the time of surgery) * Psychiatric illness that precludes informed consent * Unable to speak, read or understand the English language * Major medical illness (life expectancy less than 1 year or unacceptably high operative risk)