During the past 5 years, the controversy surround graft selection in ACL surgery has clarified a bit. Multiple peer review articles from respected ACL surgeons have documented an increased failure rate in “young” patients using allograft tissue. However, there is much more to the story.
When looking at ACL surgery results and graft selection, one has to compare apples to apples. This is difficult to do in a single study when you have so many different variables that potentially affect outcome. In the ideal world, every ACL study would include the Marx activity level of the patient. How often and intense does the patient “test” the knee, i.e., attempt ACL-dependent activities? This is critically important in that the ACL may not be so important in the majority of activities the average person does. However, it is entirely different if they participate in level 1 sports every day. Most ACL studies include both groups of patients, active and not so active. One would also compare only males to males, females to females, and the exact same “allograft” to form a cohort group. I am unaware of an ideal study that has done such.