Patient Age and Activity Level, Posterior Tibial Slope, and Use of Allograft Are Significant Risk Factors for Anterior Cruciate Ligament Reconstruction Failure: A Systematic Review.

For the 5 studies finding graft characteristics as a significant predictor for revision and 1 study finding them a significant predictor of graft failure, the most cited predictor was allograft usage as opposed to autograft, which was significant in 5 studies and trending toward significance ( P = .076) in another ( Table 6 , Table 7 ). 6 , 10 , 14 , 18 , 25 , 27 In support of this finding, in vivo sheep studies have shown allografts have delayed revascularization and recellularization, lower structural and mechanical properties, and increased anteroposterior laxity compared to autografts. 48 For patients with other factors that increase their risk of ACLR failure, the authors recommend that their surgeon consider using autograft if possible.

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