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BTB Allograft ACL Reconstruction

What is an allograft?

An allograft is a bone, ligament, cartilage, tendon or section of skin that is transplanted from one person to another. It is also referred to as “donated tissue.” Every year in the United States, doctors use more than a million allografts to help….

  • Athletic individuals who need knee reconstruction
  • People suffering from back pain
  • Cancer patients who need tumor surgery
  • Women undergoing post-mastectomy breast reconstruction

In Australia Allograft for soft tissue reconstruction is not popular. The prime reason for this is that the soft tissue grafts available in Australia are either chemically treated or Irradiated to sterilise them for implantation. Unfortunately this makes the tissue weak and resulting in high failure rates. This is definitely the case in ACL reconstruction. An ACL is a dynamic structure that has to provide stability in different degrees of knee motion. It the tissue is weak and has poor regenerative capacity - the graft will fail and the operation will have to be redone.

Understanding_Allografts_Patient_Brochure_MKTG-1248_Rev0.pdf

Why use Allograft?

Dr Kaushik Hazratwala at the Queensland Lower Limb Clinic has teamed with an American company to bring soft tissue grafts that are not chemically treated or irradiated. QLLC is amongst one of the 1st clinics in Australia to provide this option to their patients.  These grafts perform as good as autograft. These grafts have been available in the USA for very long time and multiple peer review studies show equivalent results in the short to medium term. A large study looking at infection rates after allograft use did not show any increased rates of infection.

ACLR_using_patellar_tendon_allograft_an_age-dependant_outcome_evaluation_p8.pdf

Allograft_vs_Autograft_infection_rates_p9.pdf

1_Alan_Barber_-_Revision_rates_after_ACLR_using_PTB_allograft_or_autograft_in_a_population_25_years_old_or_younger_p5.pdf

 

Why Bone-Tendon-Bone?

Bone Tendon Bone graft choice have been shown to have better outcomes in high demand individuals (athletes) when compared to Hamstring graft. One of the draw backs of the BTB graft is donor site morbidity. Meaning residual symptoms of pain or other symptom from the harvest site. With Allograft BTB there is no donor site therefore no morbidity. 

A_meta-analysis_of_patellar_tendon_autograft_Vs_patellar_tendon_allograft_in_ACLR_p23.pdf

 

Watch below Dr Hazratwala performing his suspensory fixation BTB allograft ACL Reconstruction