ACL allograft

Written by Dr Sheila Strover on March 14, 2025

An ACL allograft is a graft from a donor to reconstruct the ACL (anterior cruciate ligament). Page updated April 2024 by Dr Sheila Strover (Clinical Editor)

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.

"....risk of graft failure was found to be substantially greater in patients receiving allograft....risk for revisions was subsequently also found to be greater"

Gregor Goetz et al

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How is allograft obtained?

Allograft is human donor material from a cadaver, and which has been specially processed and stored by a laboratory.

"....Usual allograft sources for anterior cruciate ligament (ACL) reconstruction are patellar ligament, Achilles tendon, tibialis anterior, and posterior....."

Michael I Iosifidis et al

"....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 ....."

Michael I Iosifidis et al

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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.

"....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....."

Alec A Macaulay et al

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Anterior cruciate ligament reconstruction, ACL autograft, Hamstrings autograft, B-PT-B

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Forum discussions

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