Clinical Scenario: Anterior cruciate ligament (ACL) ruptures are one of the most common knee injuries. Treatment commonly involves a form of tissue graft (allograft or autograft), with an allograft being a tendon taken from a cadaver and an autograft being taken from the patient. Research suggests that autografts are recommended for individuals under the age of 35, while allografts are recommended for older people. We chose collegiate athletes because they are a unique population of young people, some
still in their developmental stage, who are required to put a high amount of stress on their bodies due to the physical demands of college athletics. The purpose of this paper is to assess which is more effective at decreasing the re-injury rate. Clinical Question: Is ACL-R autograft surgery more effective than allograft reconstruction surgery at decreasing the re-injury rate in collegiate athletes? Summary of Key Findings: Allograft ACLs have been associated with a 13 times higher re-tear rate when compared to autograft ACLs, especially in younger patients. In addition to a lower re-tear rate, autografts have been shown to have higher rates of return to sports and better patient-reported outcomes at 2 and 6 years after surgery. Clinical Bottom Line: Autografts have a lower re-tear rate than allografts. Strength of Recommendation: There is moderate-quality evidence (grade B) that autografts have a lower re-tear rate than allografts, particularly in young athletes.