Carson Palmer instantly knew when he tore his ACL on Nov. 9 in a game against the Rams
Carson Palmer’s lasting connection: By relying on donated tissue to save his knee, Palmer became one of the most high-profile beneficiaries of a fast-growing field in sports medicine: allografts. In the past decade, the use of musculoskeletal allografts — transplanting pristine replacement parts recovered from deceased human donors to repair the ravaged knees, shoulders, elbows and spines of athletes and millions of others — has quietly boomed into a billion-dollar industry, with more than 1.5 million tissue transplants each year.
English soccer star Michael Owen, Olympic snowboarder Lindsey Jacobellis, White Sox star-turned-manager Robin Ventura and UConn basketball great Caroline Doty are just a few of the hundreds of elite athletes who have come back from injury thanks to the selfless final act of a stranger. “Unfortunately, someone had to pass for my recovery to happen,” Palmer says. “If people didn’t donate, my surgery, my recovery and everything else after isn’t successful, or even possible. It’s a lot to think about, just how lucky I am.”
“There is a long, crowded history of people trying to use things to repair the body other than human tissue,” says Dr. Lonnie Paulos, Palmer’s orthopedic surgeon. “But it’s nearly impossible to fool Mother Nature.”
Donated ligament would change Palmer’s life after he tore his ACL during a game against the Steelers.
The biological truth at the center of the allograft industry is simple and profound: Humans aren’t just similar, we’re practically interchangeable. Unlike organs, which must be matched by blood type and antigens and transplanted immediately, tissue is universal. It can be recovered up to 24 hours after death, stored for years and reused regardless of age or sex. That explains why a Pro Bowl quarterback could have a new ACL created from the Achilles tendon of someone who seemed to be his exact opposite: a woman 11 inches shorter and 19 years older who’d never thrown a football more than 10 yards.
Of the 3 million people who die each year in the United States, fewer than one-tenth of 1 percent (14,257) become organ donors and roughly 30,000 share their tissue. Although few understand and appreciate it the way Palmer does, a donor’s ligament is a rare and valuable gift. Human cartilage, for example, does not regenerate. Without a replacement part, an athlete who tears a meniscus would have to spend the rest of his or her life with bone grinding against bone and the debilitating white-hot pain that goes along with it.
Since the late 1990s, when surgical pioneers like Dr. Paulos and Dr. Brian Cole of Chicago’s Rush University Medical Center made allografts so popular in ACL surgery that tissue banks began running out of tendons, AlloSource — managed by six regional OPOs — hasn’t been able to grow fast enough. In fact, the demand in orthopedic surgery is so high that an entire section of the company’s 30-page color catalog is dedicated to sports medicine. Dr. Brian Cole regularly performs cartilage restoration that allow patients to have full mobility.
Before donated tissue could become Palmer’s, however, it had to be sent to a tissue bank in New Jersey, where it was processed, cleaned, tested and stored. That facility is much like AlloSource outside of Denver, one of the country’s leading allograft hubs. AlloSource deals in skin grafts, full bone replacements, spinal grafts, osteobiologics and even stem cells. In conjunction with the Joint Restoration Foundation, it also distributes 225 tendons a week and nearly 240,000 allografts a year.