Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 27, Issue 6, pp 1771–1781 | Cite as

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

  • V. Condello
  • U. Zdanowicz
  • Berardo Di MatteoEmail author
  • T. Spalding
  • P. E. Gelber
  • P. Adravanti
  • P. Heuberer
  • S. Dimmen
  • B. Sonnery-Cottet
  • C. Hulet
  • M. Bonomo
  • E. Kon


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.


ACL Revision Allograft Multi-ligament Arthroscopy Return to sport Anterior cruciate ligament 



No funding source to be disclosed for the present manuscript.

Compliance with ethical standards

Conflict of interest

All the authors declare no conflict of interest with regard to the content of the present paper.

Ethical approval

Given the nature of the paper, no ethical approval is required.


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  • V. Condello
    • 1
  • U. Zdanowicz
    • 2
    • 3
  • Berardo Di Matteo
    • 4
    • 5
    Email author
  • T. Spalding
    • 6
  • P. E. Gelber
    • 7
    • 8
  • P. Adravanti
    • 9
  • P. Heuberer
    • 10
  • S. Dimmen
    • 11
  • B. Sonnery-Cottet
    • 12
  • C. Hulet
    • 13
  • M. Bonomo
    • 14
  • E. Kon
    • 4
    • 5
  1. 1.Department of OrthopaedicsClinica Humanitas CastelliBergamoItaly
  2. 2.Carolina Medical CenterWarsawPoland
  3. 3.McGowan Institute for Regenerative MedicineUniversity of PittsburghPittsburghUSA
  4. 4.Department of Biomedical SciencesHumanitas UniversityMilanItaly
  5. 5.Humanitas Clinical and Research CenterMilanItaly
  6. 6.University Hospitals Coventry and Warwickshire (UHCW)CoventryUK
  7. 7.Orthopaedic Department, ICATME-Institut Universitari Quirón-DexeusUniversitat Autònoma BarcelonaBarcelonaSpain
  8. 8.Orthopaedic Department, Hospital de Sant PauUniversitat AutònomaBarcelonaSpain
  9. 9.U.O. Ortopedia, Clinica “Città di Parma”ParmaItaly
  10. 10.Herz-Jesu HospitalViennaAustria
  11. 11.Lovisenberg Diaconal HospitalOsloNorway
  12. 12.Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Générale de SantéHôpital Privé Jean MermozLyonFrance
  13. 13.Department of Orthopaedic Surgery and Traumatology, Unit INSERM COMETE, UMR U1075Caen University HospitalCaenFrance
  14. 14.Orthopaedic DepartmentSacro Cuore-Don Calabria HospitalNegrarItaly

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