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Review
. 2025 Apr 22;13(4):e25.00013.
doi: 10.2106/JBJS.RVW.25.00013. eCollection 2025 Apr 1.

Myths and Facts About Allograft Use in Anterior Cruciate Ligament Reconstruction: A Detailed Review of the Literature

Benjamin R Paul  1 , Joey Robaina  2 , Romir Parmar  2 , Thomas Carter  2 , Anup Shah  2
Affiliations
Review

Myths and Facts About Allograft Use in Anterior Cruciate Ligament Reconstruction: A Detailed Review of the Literature

Benjamin R Paul et al. JBJS Rev. .

Abstract

» Patient-Specific Graft Selection: Graft selection for anterior cruciate ligament reconstruction (ACLR) requires a nuanced approach that considers various patient-specific factors, such as age, activity level, comorbidities, and surgical goals. Generally, allografts are preferred for older patients with less active lifestyles, whereas autografts are more suitable for younger, active patients because of autografts' lower retear rates.» Impact of Sterilization Techniques: Sterilization and processing techniques significantly affect the biomechanical properties and outcomes of allografts. While high-dose irradiation reduces allograft strength and compromises healing, low-dose irradiation or nonirradiated grafts offer superior biomechanical and clinical outcomes. However, standardized sterilization protocols are yet to be established.» Comparative Outcomes of Allografts and Autografts: Evaluating the literature on allografts vs. autografts in ACLR remains challenging because of the significant variability in patient characteristics, outcome measures, graft strength testing, and sterilization techniques across studies.

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Conflict of interest statement

Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSREV/B211).

Figures

Fig. 1
Fig. 1
Autograft vs. allograft decision tree. ACLR = anterior cruciate ligament reconstruction.
See this image and copyright information in PMC

References

    1. Sanders TL, Maradit Kremers H, Bryan AJ, Larson DR, Dahm DL, Levy BA, Stuart MJ, Krych AJ. Incidence of anterior cruciate ligament tears and reconstruction: a 21-year population-based study. Am J Sports Med. 2016;44(6):1502-7. - PubMed
    1. Herzog MM, Marshall SW, Lund JL, Pate V, Mack CD, Spang JT. Trends in incidence of ACL reconstruction and concomitant procedures among commercially insured individuals in the United States, 2002-2014. Sports Health. 2018;10(6):523-31. - PMC - PubMed
    1. D'Ambrosi R, Meena A, Arora ES, Attri M, Schäfer L, Migliorini F. Reconstruction of the anterior cruciate ligament: a historical view. Ann Transl Med. 2023;11(10):364. - PMC - PubMed
    1. Kaeding CC, Aros B, Pedroza A, Pifel E, Amendola A, Andrish JT, Dunn WR, Marx RG, McCarty EC, Parker RD, Wright RW, Spindler KP. Allograft versus autograft anterior cruciate ligament reconstruction: predictors of failure from a MOON prospective longitudinal cohort. Sports Health. 2011;3(1):73-81. - PMC - PubMed
    1. Duchman KR, Lynch TS, Spindler KP. Graft selection in anterior cruciate ligament surgery: who gets what and why? Clin Sports Med. 2017;36(1):25-33. - PubMed

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