Anterior cruciate ligament reconstruction with synthetic grafts. A review of literature

Legnani, Claudio; Ventura, Alberto; Terzaghi, Clara; Borgo, Enrico; Albisetti, W.

doi:10.1007/s00264-010-0963-2

Cited by 207 publications

(182 citation statements)

References 46 publications

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“…Manually applied forces and displacements are inconsistent and difficult to assess. The speed of the procedure, the angle of hip abduction during the test and the magnitude of force applied to the knee depend on the investigator and the test used [19]. Post-operatively, we found a significant reduction in laxity in both groups.…”

Section: Discussionsupporting

confidence: 58%

“…Intra-articular landmarks included the anterior edge of the PCL on the tibial plateau, the anterior horn of the lateral meniscus, the spine of the medial intercondylar tubercle, the medial notch wall, the anterior notch outlet, the lateral notch wall, the ACL insertion area on the femur, the 12 o'clock "over-the-top" position and the lateral over-the-top position. Using a special tibial aimer with attached markers, the exact location of the tibial and femoral tunnels could be selected on the basis of real-time information about the tibial plateau as seen on the OrthoPilot map [19] (Fig. 2).…”

Section: Methodsmentioning

confidence: 99%

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Application of a computerised navigation technique to assist arthroscopic anterior cruciate ligament reconstruction

Zhu

Lü

Han

et al. 2013

International Orthopaedics (SICOT)

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Purpose Based on biomechanical cadaver studies, anatomical double-bundle reconstruction of the anterior cruciate ligament (ACL) was introduced to achieve better stability in the knee, particularly in respect of rotatory loads. Previously, the success of ACL reconstruction was believed to be mainly dependent on correct positioning of the graft, irrespective of the number of bundles for which computer-assisted surgery was developed to avoid malpositioning of the tunnel. The aim of this study was to compare rotational and translational stability after computer-navigated standard single-bundle and anatomical double-bundle ACL reconstruction. Methods The authors investigated 42 consecutive patients who had undergone the single-bundle or double-bundle ACL reconstruction procedure using autogenous hamstring tendon grafts and ENDOBUTTON fixation in patients who had been followed up for a minimum of 24 months. Postoperative anteroposterior and rotational laxity was measured with the KT3000 and compared between groups. Results Both surgical procedures significantly improve rotational and translational stability compared to the preoperative ACL-deficient knee (P<0.05). No significant differences were registered between groups with regard to anteroposterior displacement of the tibia. The International Knee Documentation Committee (IKDC) and Lysholm scores were significantly higher in the double-bundle group. However, the results were excellent in both groups. Conclusions The use of computer-assisted ACL reconstruction, which is a highly accurate method of graft placement, could be useful for inexperienced surgeons to avoid malposition. Long-term results of at least five years are needed to determine whether double-bundle ACL reconstruction, which was associated with improved rotational laxity and significantly better IKDC and Lysholm scores compared to the standard single-bundle ACL reconstruction procedure, exerts an influence in terms of avoiding osteoarthritis or meniscus degeneration.

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Section: Discussionsupporting

confidence: 58%

Section: Methodsmentioning

confidence: 99%

Application of a computerised navigation technique to assist arthroscopic anterior cruciate ligament reconstruction

Zhu

Lü

Han

et al. 2013

International Orthopaedics (SICOT)

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“…Arthroscopic re-evaluation during the removal of the synthetic augmentation demonstrated a significant correlation between clinical condition, instrumental stability performance and arthroscopic graft constitution. Supplementary graft augmentation over the last few decades of ACL reconstruction represented the idea of additional graft protection during the vulnerable phase of graft integration and remodelling becoming an attractive alternative to biological grafts [7,10,11,13,14,24]. The initial enthusiasm in the 1980s for the use of artificial ligaments was based on lack of donor morbidity, abundant supply, and significant strength and immediate loading leading to a potentially shortened postoperative rehabilitation [7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

“…The initial enthusiasm in the 1980s for the use of artificial ligaments was based on lack of donor morbidity, abundant supply, and significant strength and immediate loading leading to a potentially shortened postoperative rehabilitation [7][8][9][10]. Different procedures and various materials were established for ACL reconstruction [24]. Synthetic grafts made of different materials such as carbon fibres, polypropylene, Dacron and polyester have been employed either as a single ACL prosthesis or as an augmentation for a biological ACL graft substitute [7,13,14,[24][25][26].…”

Section: Discussionmentioning

confidence: 99%

“…Different procedures and various materials were established for ACL reconstruction [24]. Synthetic grafts made of different materials such as carbon fibres, polypropylene, Dacron and polyester have been employed either as a single ACL prosthesis or as an augmentation for a biological ACL graft substitute [7,13,14,[24][25][26]. One of the most commonly used artificial augmentation devices since the 1980s is the polyethylene terephthalate (PET) ligament (Trevira®) [7].…”

Section: Discussionmentioning

confidence: 99%

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Second-look arthroscopic findings and clinical results after polyethylene terephthalate augmented anterior cruciate ligament reconstruction

Struewer¹,

Ziring

Ishaque

et al. 2012

International Orthopaedics (SICOT)

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Purpose Based on the revival of artificial ligaments containing polyethylene terephthalate, this study aimed to evaluate objective intra-articular findings within scheduled secondlook arthroscopy, patient-reported clinical outcome and stability after isolated augmented ACL reconstruction with polyethylene terephthalate (Trevira®) augmented patella-bonetendon-bone graft. Methods In a retrospective analysis of our institutional database, we found 126 patients with polyethylene terephthalate (Trevira®) augmented ACL reconstruction. All these patients underwent standardised second-look arthroscopic evaluation when removal of the augmentation became necessary. These second-look arthroscopic analyses focused on graft integration and remodelling in line with the polyethylene terephthalate augmentation. Arthroscopic re-examination comprised a graft evaluation including a structural and functional classification according to the Marburger Arthroscopy Score (MAS).Additional clinical evaluation was performed via the IKDC score and the scores of Tegner and Lysholm. Instrumental anterior laxity testing was carried out with a KT-1000™ arthrometer. Furthermore, a correlation analysis between the clinical parameters, the instrumental stability assessment and the corresponding arthroscopic graft condition was performed.Results The arthroscopic evaluation showed rupture of 87 (69 %) of 126 augmentation devices. In 27 (31 %) of these 87 cases, synovial reactions were found particularly in the anterior compartment. An intact synthetic augmentation with signs of graft integration with intact synovial coating was only found in 30 %. Evaluation according to the MAS showed good to excellent structural and functional characteristics in 88 % of patients. Presence of a type III graft (MAS) was found in an additional 11 %. A rudimentary (type IV) graft was only detected once. Eighty-five percent of patients were graded A or B according to IKDC score. The Lysholm score was 92.4± 4.8. Correlation analysis demonstrated a significant relationship between clinical outcome according to the IKDC score (p<0.05), instrumental stability performance according to the KT-1000™ assessment (p<0.05) and the corresponding arthroscopic graft evaluation according to the MAS. Conclusion Graft integration and remodelling has complex and multi-factorial origins, particularly with artificial augmentation. Correlation analysis showed a significant relation between clinical condition, instrumental stability performance and arthroscopic graft constitution. The release of polyethylene terephthalate fibres caused inflammation of synovial tissue of the knee. Characteristic sub-clinical graft changes of structural, morphological and functional qualities of the inserted graft appear on second-look arthroscopy despite good clinical results.

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Potential of Graphene–Polymer Composites for Ligament and Tendon Repair: A Review

et al. 2020

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Tendon/ligament injuries are debilitating conditions that affect the life quality of a great percentage of the adult population. Several challenges still have to be addressed regarding the repair of these tissues, as current treatments show limited success. The use of biocompatible and biodegradable polymeric scaffolds potentially helps accomplish a complete and long‐term functional repair but, unfortunately, these materials lack adequate mechanical properties to be used in such demanding applications. Graphene is a subject of interest for tissue‐repair applications due to its electrical conductivity and mechanical properties. If incorporated adequately, it may significantly improve the physical properties of the composite, even at small loadings. Furthermore, graphene presents a biocompatible surface that may enhance cell adhesion, proliferation and differentiation and demonstrates promising outcomes in several in vitro and in vivo biological applications. Therefore, herein, the potential of graphene materials for the reinforcement of biodegradable polymers of interest for tendon/ligament repair is explored. The effect of graphene on relevant features such as mechanical properties, biodegradability, and biocompatibility is revised, to understand the feasibility of these composites to fulfill the requirements associated with these tissues and conclude how their applicability is extended to this field.

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Anterior cruciate ligament reconstruction with synthetic grafts. A review of literature

Cited by 207 publications

References 46 publications

Application of a computerised navigation technique to assist arthroscopic anterior cruciate ligament reconstruction

Application of a computerised navigation technique to assist arthroscopic anterior cruciate ligament reconstruction

Second-look arthroscopic findings and clinical results after polyethylene terephthalate augmented anterior cruciate ligament reconstruction

Potential of Graphene–Polymer Composites for Ligament and Tendon Repair: A Review

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