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Allograft tendons are a safe and effective option for revision ACL reconstruction: a clinical review

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Revision anterior cruciate ligament reconstruction remains a challenge, especially optimising outcome for patients with a compromised knee where previous autogenous tissue has been used for reconstruction. Allograft tissue has become a recognized choice of graft for revision surgery but questions remain over the risks and benefits of such an option. Allograft tendons are a safe and effective option for revision ACL reconstruction with no higher risk of infection and equivalent failure rates compared to autografts provided that the tissue is not irradiated, or any irradiation is minimal. Best scenarios for use of allografts include revision surgery where further use of autografts could lead to high donor site morbidity, complex instability situations where additional structures may need reconstruction, and in those with clinical and radiologic signs of autologous tendon degeneration. A surgeon needs to be able to select the best option for the challenging knee facing revision ACL reconstruction, and in the light of current data, allograft tissue can be considered a suitable option to this purpose.

Level of evidence IV.

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Authors and Affiliations

  1. Department of Orthopaedics, Clinica Humanitas Castelli, Via Mazzini, 11, Bergamo, Italy

    V. Condello

  2. Carolina Medical Center, Pory 78, 02-757, Warsaw, Poland

    U. Zdanowicz

  3. McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, USA

    U. Zdanowicz

  4. Department of Biomedical Sciences, Humanitas University, Via Manzoni 113, Rozzano, 20089, Milan, Italy

    Berardo Di Matteo & E. Kon

  5. Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano, 20089, Milan, Italy

    Berardo Di Matteo & E. Kon

  6. University Hospitals Coventry and Warwickshire (UHCW), Coventry, UK

    T. Spalding

  7. Orthopaedic Department, ICATME-Institut Universitari Quirón-Dexeus, Universitat Autònoma Barcelona, Barcelona, Spain

    P. E. Gelber

  8. Orthopaedic Department, Hospital de Sant Pau, Universitat Autònoma, Barcelona, Spain

    P. E. Gelber

  9. U.O. Ortopedia, Clinica “Città di Parma”, Parma, Italy

    P. Adravanti

  10. Herz-Jesu Hospital, Vienna, Austria

    P. Heuberer

  11. Lovisenberg Diaconal Hospital, Lovisenberggt. 17, 0456, Oslo, Norway

    S. Dimmen

  12. Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Générale de Santé, Hôpital Privé Jean Mermoz, Lyon, France

    B. Sonnery-Cottet

  13. Department of Orthopaedic Surgery and Traumatology, Unit INSERM COMETE, UMR U1075, Caen University Hospital, Caen, France

    C. Hulet

  14. Orthopaedic Department, Sacro Cuore-Don Calabria Hospital, Via Don A. Sempreboni, 5, 37024, Negrar, VR, Italy

    M. Bonomo

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  1. V. Condello
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Condello, V., Zdanowicz, U., Di Matteo, B. et al. Allograft tendons are a safe and effective option for revision ACL reconstruction: a clinical review. Knee Surg Sports Traumatol Arthrosc 27, 1771–1781 (2019). https://doi.org/10.1007/s00167-018-5147-4

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