ACL Allograft: Advantages and When to Use

It is commonly recommended to reconstruct a torn anterior cruciate ligament in active patients; however, there is no consensus concerning the tissue source to use for the reconstruction. Bone-patellar tendon-bone and hamstring (semitendinosis +/- gracilis) autografts are most commonly used, with allografts being another option. Each tissue has its pros and cons, with allografts often cited as having higher failure rates. However, review of the literature comparing autografts and allografts have showed similar outcomes in age-matched adult populations. Some authors have had particular concern with using allografts in patients under 25 years of age, with several studies showing significantly higher failure rates with allografts versus autografts. More recent literature has shown than allografts can successfully be used in this younger age group with proper graft processing and compliance with a slower rehabilitation protocol.