Allograft of Knee Ligament Reconstruction and Posterior Cruciate Ligament Allograft

Abstract

The development of new surgical instruments as well as the development of new surgical techniques has allowed predictable outcomes in anterior cruciate ligament (ACL) reconstruction. The most common ACL reconstruction technique, as originally described by Jones1 in 1963, uses an autogenous bone-patellar tendon-bone (BPTB) graft harvested from the central one-third of the patellar tendon. Autogenous BPTB ACL reconstructions have become an increasingly popular technique with better postoperative outcomes when compared to previous open techniques. The semitendinosus,2 gracilis-semitendinosus,3 Achilles tendon,2 fascia lata,2,4 iliotibial band,5 and quadriceps tendon grafts have all been used for ACL reconstruction.6 Allograft tissue is also utilized for the reconstruction of the ACL as an alternative to using auto-graft tissue. Many authors are reporting results at least equal to the results reported with autogenous BPTB tissue for the reconstruction of the ACL.7–11 Arthroscopic allograft reconstruction provides equivalent results when compared to the standard patellar tendon autogenous graft, but the allograft has fewer postoperative complications, avoids the harvesting of otherwise healthy tissue, and has been demonstrated to be a safe and viable procedure. This overview explores the historical development of allogenic tissue constructs in knee surgery, the current trends in surgical technique, and the possibilities for future uses.