Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction: Predictors of Failure From a MOON Prospective Longitudinal Cohort.

28 Two systematic reviews found more failures in allograft ACLRs; however, the limited number of failures within the allograft group left these studies underpowered, and they did not reach statistical significance ( P > 0.05). 6 , 11 In one of these reviews, no difference was reported in the entire study group, but the authors did show a statistically significant difference between patellar tendon autografts and allografts, with the allograft group having a higher failure risk. 11 Thus, the prognostic question of whether an allograft ACLR has an increased risk of failure versus an autograft ACLR remains to be determined by either a large prospective randomized trial or a prospective longitudinal cohort with sufficient sample size, including failure events, to provide the highest level of evidence.

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