Even with the most accurate individualized, anatomic approach to anterior cruciate ligament (ACL) reconstruction, the potential for graft failure still exists, with reported retear rates as low as 5%, and even higher in female athletes or patients reconstructed with allograft. ACL graft healing is dependent on several factors, including anatomic placement, appropriate graft choice, proper technique, recovery time, and the biological environment of nature. If the double-bundle concept is followed and individualized for each patient's anatomic morphology, the ACL will biologically reform. The use of adult stem cells may help to contribute to the biological environment and aid in a faster healing time and quicker return to the preoperative state. There is a need for long-term studies and further research in human models to determine the optimal indication and environment for tissue healing with stem cell treatment.
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