Comparing allograft to autograft
An ACL allograft can be contrasted with an ACL autograft, where the patient's own tissue is harvested for the graft.
The allograft ligament is very different from autograft as it has been harvested, processed, and stored, whereas the autograft is fresh and implanted immediated back into the patient after harvest and minimal preparation.
Peer-reviewed papersQuote from peer-reviewed paper:
"....risk of graft failure was found to be substantially greater in patients receiving allograft....risk for revisions was subsequently also found to be greater"
Citation: Goetz G, de Villiers C, Sadoghi P, Geiger-Gritsch S. Allograft for Anterior Cruciate Ligament Reconstruction (ACLR): A Systematic Review and Meta-Analysis of Long-Term Comparative Effectiveness and Safety. Results of a Health Technology Assessment. Arthrosc Sports Med Rehabil. 2020 Nov 13;2(6):e873-e891. doi: 10.1016/j.asmr.2020.07.003. PMID: 33376999; PMCID: PMC7754611.
How is allograft obtained?
Allograft is human donor material from a cadaver, and which has been specially processed and stored by a laboratory.
Peer-reviewed papersQuote from peer-reviewed paper:
"....Usual allograft sources for anterior cruciate ligament (ACL) reconstruction are patellar ligament, Achilles tendon, tibialis anterior, and posterior....."
Citation: Iosifidis MI, Tsarouhas A. Allografts in Anterior Cruciate Ligament Reconstruction. Sports Injuries. 2010 Nov 12:421–30. doi: 10.1007/978-3-642-15630-4_58. PMCID: PMC7123455.
Quote from peer-reviewed paper:
"....Careful donor selection, aseptic graft procurement and processing, and tissue sterilization, by irradiation or proprietary chemical processing, are the three major steps of the graft preparation procedure ....."
Citation: Iosifidis MI, Tsarouhas A. Allografts in Anterior Cruciate Ligament Reconstruction. Sports Injuries. 2010 Nov 12:421–30. doi: 10.1007/978-3-642-15630-4_58. PMCID: PMC7123455.
Graft choice in ACL reconstruction
Because an autograft is fresh, taken from the patient during the surgery, it is likely to heal faster.
But the downside is that the patient effectively has two surgeries to heal from and the donor site sometimes proves problematic.
Peer-reviewed papersQuote from peer-reviewed paper:
"....A number of variables play a role in determining the utility of the graft options: stability, muscle strength, function, return to sports, patient satisfaction, complications, and cost. Both allografts and the 3 main options for autografts can provide excellent results in ACL reconstruction and lead to a high percentage of satisfied patients....."
Citation: Macaulay AA, Perfetti DC, Levine WN. Anterior cruciate ligament graft choices. Sports Health. 2012 Jan;4(1):63-8. doi: 10.1177/1941738111409890. PMID: 23016071; PMCID: PMC3435898.
Forum discussions
- Over 50...ACL reconstruction or not?
A broad-ranging discussion about various options for ACL reconstruction
- please give advice an graft selection, im freaking out.
A discussion about what dictates the choice of ACL graft material