Anterior cruciate ligament replacement with polyester fibre. A long-term study of tissue reactions and joint stability in sheep

Amis, Andrew A.; Camburn, M.A.; Kempson, S. A.; Radford, W. J. P.; Stead, A. C.

doi:10.1302/0301-620x.74b4.1624524

Cited by 29 publications

(26 citation statements)

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“…The bulk of the retrieved implants consisted of dense tissue containing polyester fibers, as we have noted previously in both animal 6 and human 7,12 specimens. At the site of implant failure there was a mass of disorganized implant fibers with little tissue (Fig.…”

Section: Retrieved Implantsmentioning

confidence: 65%

Failure mechanisms of polyester fiber anterior cruciate ligament implants: A human retrieval and laboratory study

Amis

Kempson²

1999

J. Biomed. Mater. Res.

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It has been hypothesized that ACL implant failure is often caused by bone impingement in knee extension following malplacement of the tibial tunnel. This study examined polyethylene terephtalate fiber ACL implants retrieved from a clinical study, and, to confirm the hypothesis, also set up a laboratory study intended to duplicate the failure mechanism. SEM and TEM examination of 25 ruptured implants gave details of fiber failure morphology, with shearing into longitudinal fibrils, followed by rupture, when the fibrils burst apart. Cadaver joints were run in a knee simulator, with deliberately impinging ACL implants. SEM examination of implants abraded in the knee in vitro showed identical fiber damage patterns, thus confirming the impingement hypothesis.

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Section: Retrieved Implantsmentioning

confidence: 65%

Failure mechanisms of polyester fiber anterior cruciate ligament implants: A human retrieval and laboratory study

Amis

Kempson²

1999

J. Biomed. Mater. Res.

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“…It had been anticipated that the DB reconstruction would cause similar tissue reactions to the OTT reconstructions studied before [4,5], but better stability and less degeneration were also expected. The opposite was found, however; the DB joints degenerated further, related to osseous resorption at the points of stress concentration where the implants entered bone tunnels.…”

Section: Discussionmentioning

confidence: 99%

“…All implants were made of polyester fibres (ICI Terylene grade 50f20 type 1001) in a parallel structure 130 mm long, with an- [5]. The TTC implant was made with 36000 filaments (2.59 kN) and the DB implant with the AMB of 12000 and the PLB of 24000 filaments.…”

Section: Implant Designmentioning

confidence: 99%

A comparative study of single-and double-bundle ACL reconstructions in sheep

Radford

Amis

Kempson

et al. 1994

Knee Surg, Sports traumatol, Arthroscopy

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Work in vitro has previously shown superior restoration of knee stability using a double-bundle anterior cruciate ligament (ACL) reconstruction compared with single bundles taken through the condyle or 'over the top'. This paper describes an animal study designed to compare the three ACL reconstructions in vivo, in order to collect data that could support the clinical use of a double-bundle reconstruction. The three methods were compared in three groups of eight sheep, the ovine ACL having a distinct double-bundle structure. Biomechanically matched polyester fibre implants were used, with 6 months in vivo. The three methods led to similar intra-articular fibrous tissue integration of the implants and no evidence of implant damage, and biomechanical testing found greater laxity than normal for all three groups. The double-bundle group, however, had more joint surface degeneration than the other groups. It was concluded that clinical use of the double-bundle reconstruction was not indicated by the results of this experiment, in view of the more complex surgery and lack of superior performance.

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“…For the purpose of ligament tissue engineering, various polymers, both natural (Fan et al, 2009; Horan et al, 2009; Tischer et al, 2007; Noth et al, 2005; Altman et al, 2002a) and synthetic (Freeman et al, 2009; Van et al, 2009; Shao et al, 2009; Fan et al, 2008; Cooper et al, 2007, 2005; Lu et al, 2005; Bourke et al, 2004; Lin et al, 1999; Amis et al, 1988, 1992), have been investigated to replace the ACL with promising results. Our long term goal is to develop a functional and integrative scaffold for ACL tissue engineering.…”

Section: Introductionmentioning

confidence: 99%

Combined effects of chemical priming and mechanical stimulation on mesenchymal stem cell differentiation on nanofiber scaffolds

Subramony¹,

Su²,

Yeager³

et al. 2014

Journal of Biomechanics

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Functional tissue engineering of connective tissues such as the anterior cruciate ligament (ACL) remains a significant clinical challenge, largely due to the need for mechanically competent scaffold systems for grafting, as well as a reliable cell source for tissue formation. We have designed an aligned, polylactide-co-glycolide (PLGA) nanofiber-based scaffold with physiologically relevant mechanical properties for ligament regeneration. The objective of this study is to identify optimal tissue engineering strategies for fibroblastic induction of human mesenchymal stem cells (hMSC), testing the hypothesis that basic fibroblast growth factor (bFGF) priming coupled with tensile loading will enhance hMSC-mediated ligament regeneration. It was observed that compared to the unloaded, as well as growth factor-primed but unloaded controls, bFGF stimulation followed by physiologically relevant tensile loading enhanced hMSC proliferation, collagen production and subsequent differentiation into ligament fibroblast-like cells, upregulating the expression of types I and III collagen, as well as tenasin-C and tenomodulin. The results of this study suggest that bFGF priming increases cell proliferation, while mechanical stimulation of the hMSCs on the aligned nanofiber scaffold promotes fibroblastic induction of these cells. In addition to demonstrating the potential of nanofiber scaffolds for hMSC-mediated functional ligament tissue engineering, this study yields new insights into the interactive effects of chemical and mechanical stimuli on stem cell differentiation.

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Anterior cruciate ligament replacement with polyester fibre. A long-term study of tissue reactions and joint stability in sheep

Cited by 29 publications

References 0 publications

Failure mechanisms of polyester fiber anterior cruciate ligament implants: A human retrieval and laboratory study

Failure mechanisms of polyester fiber anterior cruciate ligament implants: A human retrieval and laboratory study

A comparative study of single-and double-bundle ACL reconstructions in sheep

Combined effects of chemical priming and mechanical stimulation on mesenchymal stem cell differentiation on nanofiber scaffolds

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