RECONSTRUCTION OF THE CRUCIATE LIGAMENTS WITH ALLOGRAFTS - CLINICAL PERSPECTIVE AND SHORT-TERM RESULTS

Abstract

There is a continuing search for the ideal substitute for the cruciate ligaments. Autogenous tissues have been widely used as a replacement. The use of allografts is an attractive alternative: no donor side morbidity, decreased operative time, smaller incisions, especially with new endoscopic techniques, unlimited supply with a choice of graft sizes in multiple ligament reconstructions and a long shelf-life are some of the distinct advantages that allografts offer. They may be useful in circumstances where there is no suitable autologous substitute or the available tendon is too short to span the joint cavity. The preparation of an allograft requires appropriate donor selection and screening, careful surgical tissue procurement, and safe and effective processing techniques. At the present time, the issue of secondary sterilization of allografts remains controversial. Subclinical immune response and the possibility of transmission of infectious agents have to be considered. The early results in the literature and in our small series are encouraging; however, long-term results are necessary prior to widespread use of allografts in cruciate ligaments reconstructions. The authors believe that allografts should presently be reserved for use as an alternative to prosthetic ligaments in situations where autografts are unavailable or inappropriate.