The Downsides of Autografts in ACL Injuries

14 October 2015

ACL revision surgeries require replacement tissue.  The most common source of tissue is the patients themselves.  This procedure is called an autograft.  An autograft takes tissue from somewhere else on the body, usually the hamstring or patella tendon cuts a portion of it out, and then uses that tissue to replace the ACL.  

In Europe, 97% of ACL tissue replacements are Autografts.  In the US, that number is 76%.   That translates into more than half a million people (in these two parts of the world alone) who "rob Peter to pay Paul", by taking tissues from another part of their body to put into the knee. Yet, the harvest locations need all their tissues, too.   Intact systems simply work better! 

While they are common, autografts have significant downsides.  First of all, they require a painful 2nd site surgery, take longer in the operating room, induce more pain and require a longer rehabilitation period.

Autograft harvest makes the leg permanently weaker.   Kenneth R. Morse, MD, presented a study at the 2009 American Orthopaedic Society for Sports Medicine annual meeting documenting a "decrease in hamstring muscle strength in the involved extremity of patients who had undergone ACLR with hamstring autograft".  

Other autograft issues include: Increased incidence of kneeling pain, quad weakness, mobility risks, fractures, numbness, ruptures, weakness in knee flexion and more.

So, in this day and age, must we be this crude in our methods?    

The short answer is no. 19 years ago, we set out to create a way to create healthy, strong, safe tissue that could be stored and used at the time of surgery without harming the patient.  After many trials and refinements, the result is Z-Process® and Z-Lig, currently in use in Europe and with unconditional FDA approval for a US pivotal trial. Now, we can use tissue from donor animals, remove and modify the antigens that would have caused rejection and put it into a human body in a way that allows the tissue to become the patient's own tissue over time.  

No more autografts required!  Just always available, compatible tissue that keeps the rest of the body intact and strong.