Tendons harvested from donors provide an alternative to autografted material, eliminating the harvesting procedure. In general, demand for allografts far exceeds supply. Whereas multiple units of allograft bone material can be generated from one donor, only one tendon can be used per ligament repair procedure.
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The processing requirements for tendons are somewhat more involved than those for bone grafts. They have a tendency to weaken the tendon.
This is not necessarily a critical issue, as the weakest point of the graft is at the point of bone attachment and not within the body of the tendon itself. Allografts tend to have a higher failure rate during the first year of implantation but are equal to autografts in performance thereafter.
The criteria for accepting a tendon donor tends to be more stringent than for bone donation because of the physical demands placed on the tissue and because recipients tend to be younger and more active. Another complicating factor is the care needed to extract a tendon during the procurement process, which has the potential for introducing defects that would compromise the integrity of the product once implanted.
In recent years, the anterior tibialis has become the graft of choice for ACL and PCL reconstruction. This is due in part to the large cross-sectional area and natural strength of the tendon, as well as the minimal bone-tunnel size necessary for the procedure.
Arthrex Smith & Nephew DePuy Mitek Zimmer Biomet Conmed Linvatec MTF RTI Biologics Stryker LifeNet Health JRF Verocel Wright Medical Parcus Medical Medtronic Allosource Tissue Regenix Synthasome Artelon Integra LifeSciences Others include: Tissue banks, Ceterix, LifeLink, MedShape, Osiris Therapeutics, Rotation Medical, Vivex,.
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