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Lower ACLR Failure Rates in Bone-Soft Tissue Versus Soft Tissue-Only Allografts in Adults: A Systematic Review and Meta-analysis

Summary:

A systematic review and meta-analysis comparing clinical failure and graft rupture rates following anterior cruciate ligament reconstruction (ACLR) using bone-soft tissue versus soft tissue-only allografts in adult patients.

Purpose:

This study evaluates differences in clinical outcomes between nonirradiated bone-soft tissue and soft tissue-only allografts used in primary and revision ACL reconstruction. The analysis examines cumulative failure rates, graft rupture rates, and the potential influence of patient demographics and follow-up duration on outcomes.

Key Takeaways:

  • The systematic review included 14 studies evaluating bone-soft tissue and soft tissue-only allografts in adult ACL reconstruction.
  • Bone-soft tissue allografts demonstrated lower pooled cumulative failure rates (11%) compared with soft tissue-only allografts (20%).
  • Pooled graft rupture rates were 6% for bone-soft tissue allografts versus 13% for soft tissue-only allografts.
  • Findings suggest that bone-soft tissue allografts may offer advantages in reducing clinical failure following ACL reconstruction, highlighting the importance of graft selection.

Conclusion:

Bone-soft tissue allografts demonstrated lower cumulative failure rates compared with soft tissue-only allografts in adult ACL reconstruction. These findings support consideration of graft composition when selecting allografts, while emphasizing the need for further comparative research to better understand long-term clinical outcomes.

Click here to access the abstract.

Bibliography:

Tabbaa A, Atkins M, Montalvo AM, et al. Lower ACLR Failure Rates in Bone-Soft Tissue Versus Soft Tissue-Only Allografts in Adults: A Systematic Review and Meta-analysis. American Journal of Sports Medicine. 2025;53(3):734–744. doi:10.1177/03635465241250016.

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