Biology of Autograft and Allograft Healing in Anterior Cruciate Ligament Reconstruction

The graft-bone attachment site is the weak link in anterior cruciate ligament (ACL) reconstruction surgery because healing is slow and often incomplete. Each of the many graft options for ACL reconstruction surgery has different healing characteristics and potential. Autografts that allow bone-to-bone healing offer the best healing potential. An understanding of the biology of graft healing should give the surgeon context in graft selection and rehabilitation for ACL reconstruction.