Clinical Review

Allografts for Ligament Reconstruction: Where Are We Now?

Author and Disclosure Information

 

References

Discussion

Musculoskeletal allografts are gaining popularity for ligamentous reconstruction as their safety and efficacy continue to improve. With the great majority of tissue banks being accredited by the AATB and specific regulations such as NAT screening becoming common practice, infection rates and transmission of diseases have become incredibly rare. However, a thorough consideration needs to be taken into account when choosing between autograft and allograft on a case-by-case basis (Table).

Table.
Although the incidence of donor site complications is low with autografts, there are inherent risks, such as harvest site hyperesthesia, persistent numbness, cosmetic dissatisfaction, pain, weakness, functional implications, and unsuitability of the harvested graft. While it may appear that allografts may obviate donor site morbidity, one must consider the reduced potential for the donor tissue to incorporate into the host. Several studies have suggested that incorporation into the host tissue is inferior and slower for allografts. With this knowledge, factors such as clinical outcomes, future expectations, rehabilitation protocol, and individual patient characteristics all need to be considered when selecting the source of the tissue to be transplanted. Given that there is a growing need for availability of allografts, a well-rounded understanding of the biologic and physiologic aspects of the transplanted tissues is imperative. Future research will need to focus on improving the rate and quality of the biological incorporation of the transplanted graft into the host while eliminating the risk of disease transmission and infection.

Am J Orthop. 2016;45(7):446-453. Copyright Frontline Medical Communications Inc. 2016. All rights reserved.

Pages

Recommended Reading

Knee Extensor Mechanism Reconstruction With Complete Extensor Allograft After Failure of Patellar Tendon Repair
MDedge Surgery
Ulnar Collateral Ligament Repair: An Old Idea With a New Wrinkle
MDedge Surgery
Progressive Cardiomyopathy in a Patient With Elevated Cobalt Ion Levels and Bilateral Metal-on-Metal Hip Arthroplasties
MDedge Surgery
Biomechanical Evaluation of All-Polyethylene Pegged Bony Ingrowth Glenoid Fixation Techniques on Implant Micromotion
MDedge Surgery
“I Want What Kobe Had”: A Comprehensive Guide to Giving Your Patients the Biologic Solutions They Crave
MDedge Surgery
Current and Future Stem Cell Regulation: A Call to Action
MDedge Surgery
Stem Cells in Orthopedics: A Comprehensive Guide for the General Orthopedist
MDedge Surgery
Platelet-Rich Plasma (PRP) in Orthopedic Sports Medicine
MDedge Surgery
Acellular Dermal Matrix in Rotator Cuff Surgery
MDedge Surgery
Platelet-Rich Plasma Can Be Used to Successfully Treat Elbow Ulnar Collateral Ligament Insufficiency in High-Level Throwers
MDedge Surgery