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Cadaver ACL's Failing in Young Athletes

I have been seeing an alarming rate of failures (graft tearing) in young athletes who have gotten Anterior Cruciate Ligament (ACL) reconstructions with allograft (cadaver) tissue. In some of these cases, the graft tissue seems to just dissolve, almost as if no ACL reconstruction was ever done!


A recent study at the University of Pittsburgh found a 13% failure rate after ACL reconstruction using allograft in young athletes. 48% of these failed before the 9-month mark and an additional 44% failed in the first 9 months after returning to sports.


In my opinion, this is a pretty high number and as this is being reported more and more frequently in the literature, perhaps we need to reconsider use of allografts in the younger, active population, and maybe even be more restrictive in the timeframe for them returning to sports. Allograft tissue for ACL reconstruction has its advantages - quicker surgery and less pain immediately after surgery (though no long term benefit with regards to pain). That said, I don't think these reasons would outweigh the seemingly higher risk of re-tear. This is why I routinely use hamstring autograft (your own tissue) for ACL reconstructions. I have seen better short and long term results, with lesser risk.


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