Management of the Athlete’s Knee Event Recording-8. Don't Forget the Allograft. Still Can Be Used in the Appropriate Patient

Video Transcription

Video Summary

The video features Dr. Dennis Crawford, a professor of orthopedic surgery at Oregon Health and Sciences University, discussing allograft for ACL reconstruction surgery. He explains that the goals of ACL reconstruction surgery are to restore joint mechanics, protect knee structures, and improve functional capacity. Dr. Crawford discusses various factors to consider when choosing between autogenous tissue (from the patient's own body) and allogenic tissue (from a donor). These factors include the patient's age, graft type, intent to return to work or sports, associated injuries, anatomical morphology, healing potential, and surgeon's experience. He also discusses the spectrum of complications that can occur with ACL surgery, such as tunnel malposition, hardware problems, patella fracture, hematoma, infection, graft failure, stiffness, Cyclops lesions, weakness, pain, and vascular complications. Dr. Crawford notes that allografts have advantages such as preserving native anatomy, reducing complication risk, minimizing recovery downtime, and potentially lower costs. However, there are mixed findings on outcomes and failure rates compared to autografts. He emphasizes the importance of understanding graft source, processing, donor characteristics, irradiation, and other variables that can affect graft performance. Dr. Crawford concludes that allografts can be an excellent option for properly educated patients and recommends using state-of-the-art facilities that use aseptic handling of non-irradiated electron beam sterilized grafts. He also suggests choosing younger donors and using double soft tissue cylinders for optimal outcomes.

Asset Caption

Dennis C. Crawford, MD, PhD

Keywords

ACL reconstruction surgery

allograft

autogenous tissue

graft type

complications

graft performance