Historical overview of operations for anterior cruciate ligament rupture

Dandy, David J.

doi:10.1007/bf01466629

Cited by 18 publications

(10 citation statements)

References 47 publications

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“…[2][3][4] Several techniques for ligament reconstruction are currently employed, and when appropriate reconstruction materials are available and proper techniques are used, long-term success rates of approximately 85-90% have been reported. [4][5][6] Yvonne Empson is a PhD student at the Virginia Tech -Wake Forest University School of Biomedical Engineering and Sciences. She received a bachelor's degree in mechanical engineering from Virginia Tech in 1992 then worked in the aerospace industry as a materials specialist for eight years.…”

Section: Introductionmentioning

confidence: 99%

Novel matrix based anterior cruciate ligament (ACL) regeneration

et al. 2010

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Among the five ligaments in the knee the anterior cruciate ligament (ACL) is among the most important for stability and also the most commonly injured. Due to a lack of vascularization, the ACL has poor healing potential, therefore moderate to severe damage warrants medical intervention. Ligaments are complex, highly organized tissues; they are longitudinally arranged with a great deal of order that begins at the molecular level and carries through to the tissue level. The components of the ligament and their location and orientation heavily influence the tissue's mechanical behavior. ACL replacements have faced a variety of limitations that prevented their extensive use, including implant fatigue or fraying of the device. In the face of these problems, investigators have begun to examine a variety of matrix based techniques to create options for ACL repair, replacement, and regeneration. This article will discuss ACL structure and mechanics, past replacement options and their limitations, and recent tissue engineered options for ACL repair. These techniques employ a wide variety of designs, materials, and methods to heal damaged ACL tissue or regenerate lost tissue in order to regain full ACL strength and mechanics.

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Section: Introductionmentioning

confidence: 99%

Novel matrix based anterior cruciate ligament (ACL) regeneration

et al. 2010

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“…Reviewing the literature for results of primary ACL repair, the general opinion among orthopaedic researchers is that ACL repairs do not work [5,7,9,21,28]. Those investigations were based on a surgical technique which did not reflect the present understanding of ligament healing.…”

Section: Discussionmentioning

confidence: 99%

Clinical experience with PDS II augmentation for operative treatment of acute proximal ACL ruptures - 2-year follow-up

Hehl

Strecker

Richter

et al. 1999

Knee Surgery, Sports Traumatology, Arthroscopy

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The results of prospective anterior cruciate ligament (ACL) refixation in 33 patients with high proximal rupture is reported at 20-28 months' follow-up: mean age was 31.1 +/- 12.5 years. The surgical technique was a specially developed refixation of the ACL using a multiple suture loop (modified Marshall technique) augmented with intra-articular PDS II (polydioxanon, resorbable, Ethicon, Hamburg, Germany) to avoid derangement of blood circulation and to guarantee early functional rehabilitation. All patients were operated on within 7.3 +/- 4.5 days after injury. According to the IKDC evaluation score, 22 patients showed excellent and 10 patients good subjective function. Twenty regained their pre-injury level of activity. Anterior stability was tested manually and by KT-1000 max (Medmetric, San Diego). Twenty-eight patients had a firm end-point, although there was a positive Lachman test in 16 patients. Maximal joint laxity as measured by KT-1000 showed a 1-2 mm, 3-5 mm, 6-10 mm and > 10 mm anterior drawer for 16, 14, 2 and 1 patients, respectively. Twenty-five of the evaluated knee joints had a negative pivot shift test. Three patients had a limited range of motion. The potential advantages of PDS II-augmented refixation of acute proximal ACL ruptures are anatomic reconstruction without destruction of other anatomic structures used as grafts, early functional rehabilitation and possibly better proprioception.

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“…4 A number of repair techniques are currently available, and the success rates for long term clinical outcome are 85%-90%. [5][6][7] The ACL is a dense, highly organized, cablelike tissue composed of types I, III, and V collagen, elastin, proteoglycans, water, and cells. Ligaments have a hierarchical structure with increasing levels of longitudinal organization; collagen molecules form fibrils, multiple fibrils form fibril bundles, and fibril bundles combine to form fascicles, Figure 1.…”

Section: Introductionmentioning

confidence: 99%

“…4 A number of repair techniques are currently available, and the success rates for long term clinical outcome are 85%–90%. 5–7…”

Section: Introductionmentioning

confidence: 99%

Tissue Engineering Options for Ligament Healing

Freeman

2009

Bone�Tissue�Regen�Insights

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Abstract:The anterior cruciate ligament (ACL) is one of five ligaments in the knee that are important for stability and kinematics. It is also the most commonly injured ligament of the knee and due to its poor healing potential, severe damage warrants surgical intervention including complete replacement. Ligaments are longitudinally arranged, complex tissues; the mechanical properties of ligaments are a direct result of their components and the arrangement of these components in the tissue. It is these mechanics that have made ligaments so difficult to replace. Past ACL replacements have had many limitations that prevented their extensive use. These limitations range from mechanical fatigue over time to fraying of the device after implantation. In light of these problems, investigators have begun to pursue a host of new techniques to create a range of viable options for the repair, replacement, and/or regeneration of the ACL. These options include tissue engineered scaffolds with novel designs and specially treated transplanted tissues. In this article, the composition, arrangement, and mechanics of the ACL will be discussed in order to elucidate important aspects of ACL repair; past replacements will also be discussed. Afterwards, novel replacement options that look to solve problems faced by older replacement options will be presented. These devices use a wide variety of materials and designs to replicate ligament mechanics and allow for new tissue regeneration.

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Historical overview of operations for anterior cruciate ligament rupture

Abstract: The evolution of the surgical management of anterior cruciate ligament rupture is critically reviewed. Special attention is paid to obsolete techniques or concepts which were once accepted with enthusiasm and important work that passed unnoticed.

Cited by 18 publications

References 47 publications

Novel matrix based anterior cruciate ligament (ACL) regeneration

Novel matrix based anterior cruciate ligament (ACL) regeneration

Clinical experience with PDS II augmentation for operative treatment of acute proximal ACL ruptures - 2-year follow-up

Tissue Engineering Options for Ligament Healing

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