title: Allografts in soft tissue reconstructive procedures: important considerations.
abstract: BACKGROUND
  Allografts offer several important advantages over autografts in musculoskeletal reconstructive procedures, such as anterior cruciate ligament reconstruction. Despite growing widespread use of allograft tissue, serious concerns regarding safety and functionality remain. We discuss the latest knowledge of the potential benefits and risks of allograft use and offer a critical review of allograft tissue regulation, management, and sterilization to enable the surgeon to better inform athletes considering reconstructive surgery options.
  
  
  METHODS
  A review of sources published in the past 10 years is the primary basis of this research.
  
  
  METHODS
  Observational analysis (cohort study).
  
  
  METHODS
  Level 3.
  
  
  RESULTS
  Comparable outcome data for autografts and allografts do not support universal standards for anterior cruciate ligament reconstruction, and physician recommendation and bias appear to significantly influence patient preference and satisfaction. Sterilization by gamma and electron-beam irradiation diminishes the biomechanical integrity of allograft tissue, but radioprotective agents such as collagen cross-linking and free radical scavengers appear to have potential in mitigating the deleterious effects of irradiation and preserving tissue strength and stability.
  
  
  CONCLUSIONS
  Allografts offer greater graft availability and reduced morbidity in orthopaedic reconstructive procedures, but greater expansion of their use by surgeons is challenged by the need to maintain tissue sterility and biomechanical functionality. Advances in the radioprotection of irradiated tissue may lessen concerns regarding allograft safety and structural stability.
authors.affiliation: Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Andrius
authors.initials: A
authors.lastname: Giedraitis
authors.affiliation: Laboratory for Comparative Orthopaedic Research, Michigan State University, East Lansing, Michigan.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Arnoczky
authors.affiliation: Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Asheesh
authors.initials: A
authors.lastname: Bedi
keywords: allograft; anterior cruciate ligament reconstruction; disease transmission; irradiation; sterilization; tissue biomechanics; transplantation