BIOLOGIC INCORPORATION OF ALLOGRAFT ANTERIOR CRUCIATE LIGAMENT REPLACEMENTS

Soft tissue allografts allow the orthopaedic surgeon to reconstruct li gaments without having to harvest additional tissue from the patient, which can eliminate donor tissue site morbidity and reduce surgical ti me, There is still much to be learned about the biologic aspects of th e remodeling and incorporation of allografts in comparison with autogr afts, The interaction of cells, matrix, and biomolecules, such as grow th factors, plays an important role that can potentially modulate, enh ance, or impede the healing response in allografts, The authors have s hown that, in the short term, allografts used in anterior cruciate lig ament reconstruction are not as rapidly remodeled and incorporated int o host tissue as are autografts, The long-term implications of this sl ower allograft incorporation in anterior cruciate ligament reconstruct ion are still unknown, The cells that repopulate allografts and autogr afts favor production of smaller diameter collagen fibrils, which in s ufficient numbers can provide significant strength, Use of allografts raises other issues and potential disadvantages, including scarcity, i mmunogenicity, the potential for disease transmission, and cost-effect iveness in anterior cruciate ligament reconstruction.