Allografts for the Reconstruction of the Cruciate Ligaments of the Knee: Procurement, Sterilization, and Storage

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SummaryImprovements in arthroscopic techniques stimulated an upsurge in arthroscopically assisted anterior cruciate ligament (ACL) reconstructions and in the use of fascia lata, bone-patella tendon-bone, and Achilles tendon allografts in these operations. Biomechanically and biologically aseptically excised and processed frozen or freeze-dned allografts appear to be comparable to autografts. Complications have been reported with ethylene oxide sterilized allografts. These have been attributed to the residues of ethylene oxide sterilization. Irradiated allografts are biomechanically weaker than their nonirradi-ated counterparts. Of concern to orthopaedic surgeons is the possibility of transmission of HIV and other infections with allografts used in ACL reconstructions. This possibility can be minimized by careful multiphase screening and laboratory investigations of donors from whom the allografts are obtained. Orthopaedic surgeons should be familiar with this process and with the risks associated with omissions of steps in this comprehensive process.

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