Myths and Facts About Allograft Use in Anterior Cruciate Ligament Reconstruction: A Detailed Review of the Literature.

JBJS Rev · Apr 01 2025 · Review

Paul BR, Robaina J, Parmar R, Carter T, Shah A

Department of Orthopedic Surgery, University of Arizona College of Medicine-Phoenix, Phoenix

Sports Medicine

SUMMARY — THE REDUCTIONAllograft selection for ACL reconstruction depends on patient age and activity; low-dose irradiation preserves biomechanical properties better than high-dose.
Abstract, as published

» Patient-Specific Graft Selection: Graft selection for anterior cruciate ligament reconstruction (ACLR) requires a nuanced approach that considers various patient-specific factors, such as age, activity level, comorbidities, and surgical goals. Generally, allografts are preferred for older patients with less active lifestyles, whereas autografts are more suitable for younger, active patients because of autografts' lower retear rates.» Impact of Sterilization Techniques: Sterilization and processing techniques significantly affect the biomechanical properties and outcomes of allografts. While high-dose irradiation reduces allograft strength and compromises healing, low-dose irradiation or nonirradiated grafts offer superior biomechanical and clinical outcomes. However, standardized sterilization protocols are yet to be established.» Comparative Outcomes of Allografts and Autografts: Evaluating the literature on allografts vs. autografts in ACLR remains challenging because of the significant variability in patient characteristics, outcome measures, graft strength testing, and sterilization techniques across studies.

Featured in the 2026-07-16 issue.

← A practical guide to the development and deployment of deep l…Kappa Delta Elizabeth Winston Lanier Award: Understanding the… →

The Reduction is a free email digest of newly published orthopaedic literature — a handful of new papers in the subspecialties you choose, each summarized like this one. Subscribe free or browse the archive.