Allograft ACL Reconstruction

When the ACL (anterior cruciate ligament) is torn or incompetent, it can allow your knee to shift or buckle, particularly with twisting or cutting maneuvers. When the anterior cruciate ligament is completely torn, which is the case in approximately 95% of ACL injuries, it has little ability to heal and a new ligament must be created.  A number of different graft (substitute ligament) options are available to replace the damaged ACL, which generally won’t heal, even if sewn back together.  An allograft (tissue harvested in a sterile manner from a cadaver) substitute may be appropriate for some patients.  For those with a torn ACL who are not necessarily high demand or involved in competitive sports, an allograft may be an attractive option.  Studies have suggested that it may not be a good choice for younger, aggressive patients who need an ACL reconstruction.  A number of different allografts are available including the patellar tendon, Achilles tendon, hamstring, and lower leg tendons.  The allografts may be somewhat slower to incorporate into your knee, but rejection of the graft has not been recognized as such in a manner similar to other organ transplants.  One advantage of an allograft is that it eliminates the need to harvest and sacrifice other tissues from around your knee to create the new ACL.  One drill hole is created in the upper end of the tibia and a second one in the lower end of the thighbone (femur).  These tunnels are place at the exact attachment sites for the normal ACL.  The graft is then passed into the tunnels, and secured at either end.  It passes along the same course as your normal ACL did.  Physical therapy to restore knee motion, leg strength, and agility is prescribed.  Rehabilitation and recovery of full activities generally requires 7 – 9 months.

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