Despite the long-term experience with the use of both human tendon allografts and autografts in anterior cruciate ligament (ACL) reconstruction procedures, there remains no clear consensus on overall graft preference. While bone-patellar tendon-bone (BPTB) autografts were once considered the gold standard, modern advances and availability have made the allograft option more appealing to surgeons and patients alike. With the number of ACL reconstructions increasing every year, it is important for surgeons to have current knowledge about the advantages and disadvantages for each graft source. This paper will compare the effectiveness of allografts and autografts in ACL reconstruction procedures with regard to postoperative outcomes and complications, biologic incorporation and laxity, athletic rehabilitation, athletic participation, functional limitations, pain, and cost.
