Health Problem: The anterior cruciate ligament (ACL) is 1 of 4 major ligaments in the knee joint that maintain stability of the joint. Most ACL injuries are complete or near-complete tears resulting in substantial joint instability.

Technology Description: ACL reconstruction is a surgical procedure in which a torn ACL is replaced with a tendon graft retrieved from the patient’s body (autograft) or a human donor, usually a cadaver (allograft). This report focuses on the comparison of nonirradiated allografts with autografts for primary reconstruction of ACL injuries.

Controversy: Use of an autograft tendon is associated with donor site morbidity, longer surgical times, and the risk of unsuitability of harvested graft material (e.g., insufficient graft size, poor quality). While allografts overcome these limitations, they carry risks of infectious agent transmission, immune response, and delayed incorporation.

Key Questions:

  • Are nonirradiated allografts effective in repairing knee function following anterior cruciate ligament (ACL) reconstruction?
  • How do nonirradiated tendon allografts compare with autografts with regard to knee function following ACL reconstruction?
  • Are nonirradiated tendon allografts safe?
  • Have definitive patient selection criteria been identified for the use of nonirradiated allografts?

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