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hi my name is dr. Nima Metron and Im an orthopedic surgeon in Southern California when a patient tears our ACL one of the most important discussions we have is which graph to use to reconstruct their torn ACL the first thing we do is decide between autograph the rotation in allograph the cadaver tissue and my patients who are younger such as those under 25 or even 30 and those who are high level athletes such as high school college or professional level athletes the decision is easy I tend to want to use their own tissue using their own tissue as a 5 times lower likelihood of re tearing compared to using that of a cadaver patients over 40 or patients who are very low demand athletes using a cadaver tissue can be a very good option however in patients who are over 40 whether you use allograft that could have a Guilder tissue or autograph their own tissue the rates of retail has been shown to be almost similar the most common option in high-level athletes currently in the United States