Skip to main content
SpringerLink
Log in

ACL Reconstruction, Single-Bundle Allograft

  • Chapter
  • First Online:
Arthroscopy

  • 2734 Accesses

Abstract

Using allografts can be an excellent option for ACL reconstructions in selected patients. Especially in severely injured knees or revision cases, the use of allografts can limit additional soft tissue damage, reduce surgical time, and offer reconstruction options in cases where autologous options were previously exhausted. This chapter aims to summarize the risks and benefits of allograft applications in ACL reconstruction and to increase knowledge of graft selection, procurement, sterilization, and preservation techniques. Using the right type of allograft is essential to its successful application in ACL reconstruction.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Bhatia S, Bell R, Frank RM, Rodeo SA, Bach Jr BR, Cole BJ, Chubinskaya S, Wang VM, Verma NN. Bony incorporation of soft tissue anterior cruciate ligament grafts in an animal model: autograft versus allograft with low-dose gamma irradiation. Am J Sports Med. 2012;40(8):1789–98.

    Article  PubMed  Google Scholar 

  2. Carey JL, Dunn WR, Dahm DL, Zeger SL, Spindler KP. A systematic review of anterior cruciate ligament reconstruction with autograft compared with allograft. J Bone Joint Surg Am. 2009;91(9):2242–50.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Chougule S, Tselentakis G, Stefan S, Stefanakis G. Revision of failed anterior cruciate ligament reconstruction with quadrupled semitendinosus allograft: intermediate-term outcome. Eur J Orthop Surg Traumatol. 2015;25(3):515–23.

    Article  CAS  PubMed  Google Scholar 

  4. Christel P, Djian P. Anterio-lateral extra-articular tenodesis of the knee using a short strip of fascia lata. Rev Chir Orthop Reparatrice Appar Mot. 2002;88(5):508–13.

    CAS  PubMed  Google Scholar 

  5. Dejour DZS, Ntagiopoulos PG, Grassi A, Muccioli GMM, Marcacci M. ACL reconstruction with extra-articular plasty. In: Siebold RD, Zaffagnini D, editors. Anterior cruciate reconstruction, a practical surgical guide, vol. 1. Heidelberg: Springer; 2014. p. 299–317.

    Chapter  Google Scholar 

  6. Engebretsen L, Lew WD, Lewis JL, Hunter RE. The effect of an iliotibial tenodesis on intraarticular graft forces and knee joint motion. Am J Sports Med. 1990;18(2):169–76.

    Article  CAS  PubMed  Google Scholar 

  7. Ferretti A, Conteduca F, Monaco E, De Carli A, D’Arrigo C. Revision anterior cruciate ligament reconstruction with doubled semitendinosus and gracilis tendons and lateral extra-articular reconstruction. J Bone Joint Surg Am. 2006;88(11):2373–9.

    Article  PubMed  Google Scholar 

  8. Ferretti A, Conteduca F, Monaco E, De Carli A, D’Arrigo C. Revision anterior cruciate ligament reconstruction with doubled semitendinosus and gracilis tendons and lateral extra-articular reconstruction. Surgical technique. J Bone Joint Surg Am. 2007;89(Suppl 2 Pt.2):196–213.

    PubMed  Google Scholar 

  9. Fideler BM, Vangsness Jr CT, Lu B, Orlando C, Moore T. Gamma irradiation: effects on biomechanical properties of human bone-patellar tendon-bone allografts. Am J Sports Med. 1995;23(5):643–6.

    Article  CAS  PubMed  Google Scholar 

  10. Fideler BM, Vangsness Jr CT, Moore T, Li Z, Rasheed S. Effects of gamma irradiation on the human immunodeficiency virus. A study in frozen human bone-patellar ligament-bone grafts obtained from infected cadavera. J Bone Joint Surg Am. 1994;76(7):1032–5.

    CAS  PubMed  Google Scholar 

  11. Foster TE, Wolfe BL, Ryan S, Silvestri L, Kaye EK. Does the graft source really matter in the outcome of patients undergoing anterior cruciate ligament reconstruction? An evaluation of autograft versus allograft reconstruction results: a systematic review. Am J Sports Med. 2010;38(1):189–99.

    Article  PubMed  Google Scholar 

  12. Fox JA, Pierce M, Bojchuk J, Hayden J, Bush-Joseph CA, Bach Jr BR. Revision anterior cruciate ligament reconstruction with nonirradiated fresh-frozen patellar tendon allograft. Arthroscopy. 2004;20(8):787–94.

    Article  PubMed  Google Scholar 

  13. Goddard M, Bowman N, Salmon LJ, Waller A, Roe JP, Pinczewski LA. Endoscopic anterior cruciate ligament reconstruction in children using living donor hamstring tendon allografts. Am J Sports Med. 2013;41(3):567–74.

    Article  PubMed  Google Scholar 

  14. Hampton DM, Lamb J, Klimkiewicz JJ. Effect of donor age on patellar tendon allograft ACL reconstruction. Orthopedics. 2012;35(8):e1173–6.

    Article  PubMed  Google Scholar 

  15. Hewison CE, Tran MN, Kaniki N, Remtulla A, Bryant D, Getgood AM. Lateral extra-articular tenodesis reduces rotational laxity when combined with anterior cruciate ligament reconstruction: a systematic review of the literature. Arthroscopy. 2015;31(10):2022–34.

    Google Scholar 

  16. Hinsenkamp M, Muylle L, Eastlund T, Fehily D, Noel L, Strong DM. Adverse reactions and events related to musculoskeletal allografts: reviewed by the World Health Organisation Project NOTIFY. Int Orthop. 2012;36(3):633–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Hoher J, Moller HD, Fu FH. Bone tunnel enlargement after anterior cruciate ligament reconstruction: fact or fiction? Knee Surg Sports Traumatol Arthrosc. 1998;6(4):231–40.

    Article  CAS  PubMed  Google Scholar 

  18. Hu J, Qu J, Xu D, Zhou J, Lu H. Allograft versus autograft for anterior cruciate ligament reconstruction: an up-to-date meta-analysis of prospective studies. Int Orthop. 2013;37(2):311–20.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Jackson DW, Windler GE, Simon TM. Intraarticular reaction associated with the use of freeze-dried, ethylene oxide-sterilized bone-patella tendon-bone allografts in the reconstruction of the anterior cruciate ligament. Am J Sports Med. 1990;18(1):1–10; discussion 10–11.

    Article  CAS  PubMed  Google Scholar 

  20. Kang RW, Strauss EJ, Barker JU, Bach Jr BR. Effect of donor age on bone mineral density in irradiated bone-patellar tendon-bone allografts of the anterior cruciate ligament. Am J Sports Med. 2011;39(2):380–3.

    Article  PubMed  Google Scholar 

  21. Keitel S. Guide to the quality and safety of tissues and cells for human application, European Directorate for the Quality of Medicines & HealthCare (EDQM). Strasbourg: Council of Europe; 2013.

    Google Scholar 

  22. Kraeutler MJ, Bravman JT, McCarty EC. Bone-patellar tendon-bone autograft versus allograft in outcomes of anterior cruciate ligament reconstruction: a meta-analysis of 5182 patients. Am J Sports Med. 2013;41(10):2439–48.

    Article  PubMed  Google Scholar 

  23. Krych AJ, Jackson JD, Hoskin TL, Dahm DL. A meta-analysis of patellar tendon autograft versus patellar tendon allograft in anterior cruciate ligament reconstruction. Arthroscopy. 2008;24(3):292–8.

    Article  PubMed  Google Scholar 

  24. Leathers MP, Merz A, Wong J, ScottT, Wang JC, Hame SL. Trends and demographics in anterior cruciate ligament reconstruction in the United States. J Knee Surg. 2015;28(5):390–94.

    Google Scholar 

  25. Lemaire M. Chronic knee instability. Technics and results of ligament plasty in sports injuries. J Chir (Paris). 1975;110(4):281–94.

    CAS  Google Scholar 

  26. Lind M, Menhert F, Pedersen AB. Incidence and outcome after revision anterior cruciate ligament reconstruction: results from the Danish registry for knee ligament reconstructions. Am J Sports Med. 2012;40(7):1551–7.

    Article  PubMed  Google Scholar 

  27. Mahirogullari M, Ferguson CM, Whitlock PW, Stabile KJ, Poehling GG. Freeze-dried allografts for anterior cruciate ligament reconstruction. Clin Sports Med. 2007;26(4):625–37.

    Article  PubMed  Google Scholar 

  28. Mascarenhas R, Erickson BJ, Sayegh ET, Verma NN, Cole BJ, Bush-Joseph C, Bach Jr BR. Is there a higher failure rate of allografts compared with autografts in anterior cruciate ligament reconstruction: a systematic review of overlapping meta-analyses. Arthroscopy. 2015;31(2):364–72.

    Article  PubMed  Google Scholar 

  29. Mascarenhas R, McConkey MO, Forsythe B, Harner CD. Revision anterior cruciate ligament reconstruction with bone-patellar tendon-bone allograft and extra-articular iliotibial band tenodesis. Am J Orthop (Belle Mead NJ). 2015;44(4):E89–93.

    Google Scholar 

  30. Mayr HO, Willkomm D, Stoehr A, Schettle M, Suedkamp NP, Bernstein A, Hube R. Revision of anterior cruciate ligament reconstruction with patellar tendon allograft and autograft: 2- and 5-year results. Arch Orthop Trauma Surg. 2012;132(6):867–74.

    Article  PubMed  Google Scholar 

  31. Murphy MV, Du DT, Hua W, Cortez KJ, Butler MG, Davis RL, DeCoster T, Johnson L, Li L, Nakasato C, Nordin JD, Ramesh M, Schum M, Von Worley A, Zinderman C, Platt R, Klompas M. The utility of claims data for infection surveillance following anterior cruciate ligament reconstruction. Infect Control Hosp Epidemiol. 2014;35(6):652–9.

    Article  PubMed  Google Scholar 

  32. Park SS, Dwyer T, Congiusta F, Whelan DB, Theodoropoulos J. Analysis of irradiation on the clinical effectiveness of allogenic tissue when used for primary anterior cruciate ligament reconstruction. Am J Sports Med. 2015;43(1):226–35.

    Article  PubMed  Google Scholar 

  33. Prodromos C, Joyce B, Shi K. A meta-analysis of stability of autografts compared to allografts after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2007;15(7):851–6.

    Article  PubMed  Google Scholar 

  34. Rappe M, Horodyski M, Meister K, Indelicato PA. Nonirradiated versus irradiated Achilles allograft: in vivo failure comparison. Am J Sports Med. 2007;35(10):1653–8.

    Article  PubMed  Google Scholar 

  35. Reverte-Vinaixa MM, Minguell J, Joshi N, Diaz-Ferreiro EW, Duarri G, Carrera L, Castellet E. Revision anterior cruciate ligament reconstruction using tibial or hamstring tendon allografts. J Orthop Surg (Hong Kong). 2014;22(1):60–4.

    Google Scholar 

  36. Shelton WR. Collateral ligament augmentation versus reconstruction using allograft tissue. Clin Sports Med. 2009;28(2):303–10, ix.

    Article  PubMed  Google Scholar 

  37. Tibor LM, Long JL, Schilling PL, Lilly RJ, Carpenter JE, Miller BS. Clinical outcomes after anterior cruciate ligament reconstruction: a meta-analysis of autograft versus allograft tissue. Sports Health. 2010;2(1):56–72.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Trojani C, Beaufils P, Burdin G, Bussiere C, Chassaing V, Djian P, Dubrana F, Ehkirch FP, Franceschi JP, Hulet C, Jouve F, Potel JF, Sbihi A, Neyret P, Colombet P. Revision ACL reconstruction: influence of a lateral tenodesis. Knee Surg Sports Traumatol Arthrosc. 2012;20(8):1565–70.

    Article  PubMed  Google Scholar 

  39. Werner BC, Yang S, Looney AM, Gwathmey FW Jr. Trends in pediatric and adolescent anterior cruciate ligament injury and reconstruction. J Pediatr Orthop. Epub ahead of print, doi: 10.1097/BPO.0000000000000482.

    Google Scholar 

  40. Yanke AB, Bell R, Lee A, Kang RW, Mather 3rd RC, Shewman EF, Wang VM, Bach Jr BR. The biomechanical effects of 1.0 to 1.2 Mrad of gamma irradiation on human bone-patellar tendon-bone allografts. Am J Sports Med. 2013;41(4):835–40.

    Article  PubMed  Google Scholar 

  41. Yao LW, Wang Q, Zhang L, Zhang C, Zhang B, Zhang YJ, Feng SQ. Patellar tendon autograft versus patellar tendon allograft in anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Eur J Orthop Surg Traumatol. 2015;25(2):355–65.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors would like to thank BISLIFE (the Dutch tissue bank) and in particular Marja van Wijk and Ina Kloosterboer for their assistance with this book chapter (www.bislife.org).

Author information

Authors and Affiliations

  1. John Radcliffe Trauma Service, Oxford University Hospitals NHS Trust, Oxford, UK

    Jakob Van Oldenrijk

  2. John Radcliffe Trauma Service, Oxford University Hospitals NHS Trust, Oxford, UK

    Peter A. J. De Leeuw

  3. Department of Orthopedic Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Gino M. M. J. Kerkhoffs

  4. Academic Center of Evidence based Sports medicine (ACES), Amsterdam, The Netherlands

    Gino M. M. J. Kerkhoffs

  5. Amsterdam Collaboration for Health and Safety in Sports (ACHSS), Amsterdam, The Netherlands

    Gino M. M. J. Kerkhoffs

Authors
  1. Jakob Van Oldenrijk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter A. J. De Leeuw
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gino M. M. J. Kerkhoffs
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gino M. M. J. Kerkhoffs .

Editor information

Editors and Affiliations

  1. San Donato Milanese, Milano, Italy

    Pietro Randelli

  2. Lyon, France

    David Dejour

  3. Academic Med Ctr, Orthopedic Surger, Univ of Amsterdam, Amsterdam, The Netherlands

    C. Niek van Dijk

  4. Istituto Clinico Humanitas, Rozzano, Milan, Italy

    Matteo Denti

  5. Dept Orthopedic Surgery & Sports Meds, Ctr Hospitalier Clinique d’Eich, Luxemburg, Luxembourg

    Romain Seil

Rights and permissions

Reprints and permissions

Copyright information

© 2016 ESSKA

About this chapter

Cite this chapter

Van Oldenrijk, J., De Leeuw, P.A.J., Kerkhoffs, G.M.M.J. (2016). ACL Reconstruction, Single-Bundle Allograft. In: Randelli, P., Dejour, D., van Dijk, C., Denti, M., Seil, R. (eds) Arthroscopy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-49376-2_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-49376-2_23

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-49374-8

  • Online ISBN: 978-3-662-49376-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation