Allograft ACL Reconstruction
Allograft tissue is graft material that is taken from deceased patients. The graft is typically sterilized with radiation and is stored as frozen tissue in a variety of different tissue banks.
There are some potential benefits with the use of allograft. Harvesting autograft (the patients own tissue) is one of the more technically demanding aspects of ACL reconstruction and requires significant surgical experience and adds time to the procedure. Allograft can simply be easier and faster--especially for the surgeon who does fewer ACL surgeries annually. Also, for the patient there is measurably less postoperative pain and stiffness after surgery, largely because of the lack of donor site pain.
However, there are also significant problems with the use of allografts. Some of the problems are related to tissue acquisition, storage, and transfer. Disease transmission (HIV, hepatitis, etc) is extremely rare, but 63 cases have been reported in the U.S. In the last 10 years.
The main problem with use of allograft is related to the reality that this tissue is dead. Allograft healing is inferior, takes a long time, and is incomplete. Slow healing allograft frequently results in loose knees, painful knees, and recurrent tears.
Also, allograft ligaments are not matched to the patient biologically. These grafts commonly result in host-graft reactions resulting in chronic swelling, pain, and loss of bone around the allograft. Recurrent ACL tears are significantly more common after allograft reconstructions. The bone loss related to the use of allograft can make subsequent reconstruction very difficult.