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Torn ACL: Is Cadaver Tissue the Right Fix?

July 10, 2008 -- Young, athletic patients who have surgery to repair a torn ACL in their knee could eventually need another procedure if tissue from a cadaver is used during the reconstruction.

Study results presented today at the 2008 American Orthopaedic Society for Sports Medicine's Annual Meeting in Orlando, Fla., have found that ACL reconstructions that use cadaver tissue fail in 23% of patients younger than 40.

An estimated 100,000 anterior cruciate ligament (ACL) reconstructions are performed each year in the United States. About 20% of ACL reconstructions in the U.S. use cadaver donor tissue, according to the researchers.

ACL injuries are more common in people who participate in strenuous athletic activities and high-risk sports. Pro golfer Tiger Woods, 32, recently underwent ACL reconstruction on his left knee after winning this year's U.S. Open in a sudden-death playoff. It is unknown which type of tissue was used in his procedure.

ACL reconstructions can be performed using one's own tissue or cadaver tissue, which is donated tissue from a deceased person. The choice is a decision that the surgeon and patient must make together after weighing options.

For the current study, Kurre Luber, MD, an orthopedic surgery fellow at Mississippi Sports Medicine and Orthopaedic Center, and colleagues analyzed data from 64 patients with an average age of 28 who had ACL surgery using cadaver tissue. After two years of follow up, 15 of the patient's ACL reconstructions had failed. The surgery was considered to be a failure if the patient needed a second ACL surgery or had a poor score on orthopedic-related tests.

"This study found a very high failure rate in patients 40 years and younger with high activity levels in ACL-dependent sports like tennis, basketball, soccer, and downhill skiing," Luber says in a statement.

The study authors say the failure rate is "exceedingly high" when compared to previous study findings that revealed a 2.4% failure rate for cadaver replacements in adults over 40.

"While there are obvious benefits of using the cadaver ligament, like avoiding a second surgical site on the patient, a quicker return to work and less postoperative pain, for a young patient who is very active, it may not be the right choice," study researcher Gene Barrett says in a news release.