Reconstruction of the anterior cruciate ligament using the polyester ABC ligament scaffold

Abstract

We carried out a prospective study of 71 patients who had undergone reconstruction of the anterior cruciate ligament with the ABC scaffold. Their mean age was 28 years (18 to 50). All had either sub-acute or chronic traumatic deficiency of the ligament. The mean period of follow-up was five years (four to seven). Assessment included the use of the International Knee Documentation Committee score, the modified Lysholm score, the Tegner Activity score, the Knee Injury and Osteoarthritis Outcome score and measurement with the KT-1000 arthrometer. Two patients had mild recurrent synovitis. There were no infections and no failures of the ligament. During the period of study, two patients sustained a traumatic fracture of a femoral condyle. The implants retained their integrity in both cases. All patients returned to their previous or enhanced levels of daily activity by three months after operation and 56 (79%) achieved their pre-injury level of sporting activity by six months. The patients who were competing in National level sports returned to play at one level less after operation than before. The Lysholm score showed that 58% of the patients (41) were excellent, 34% (24) good, and 8% (6) fair, with a mean post-operative score of 93. According to the International Knee Documentation Committee score, 35% of knees (25) were 'normal', 52% (37) 'nearly normal' and 13% (9) 'abnormal'. Complete satisfaction was noted in 90% of patients (64). The development of osteoarthritis and the management of anterior cruciate deficiency associated with laxity of the medial collateral ligament remains uncertain. Our results indicate that in the medium-term, the ABC ligament scaffold is suitable and effective when early and safe return to unrestricted activities is demanded. We acknowledge the current general hostility towards reconstruction of the anterior cruciate ligament with artificial materials following reports of early failure and chronic synovitis associatiated with the production of particulate debris. We did not encounter these problems.

LARS Artificial Ligament Versus ABC Purely Polyester Ligament for Anterior Cruciate Ligament Reconstruction

“…Our results were markedly different, with a 42% failure rate at a mean follow-up of 5.1 years. We cannot readily explain the significant differences between our study and that by Petrou et al, 45 but our results are similar to those of Jadeja et al 23 …”

“…Petrou et al 45 reported on a series of ABC ligaments placed using the newer instruments via an arthrotomy and an accelerated rehabilitation program. They found a survival rate of 100% at follow-up of 4 to 7 years.…”

Anterior cruciate ligament reconstruction: a systematic review of polyethylene terephthalate grafts

“…Eleven articles were identified with greater than 4‐year outcomes for other PET grafts 13–23 (seven Leeds‐Keio grafts, two ABC Surgicraft, one Proflex and one Ligastic) shown in Table 5.…”

Anterior cruciate ligament prostheses using biotextiles

“…There were no failures and only two patients suffered from recurrent synovitis. 169 The advantage of tissue-engineered ligament is that it does not elicit a permanent foreign body reaction, as it is gradually reabsorbed and replaced by natural tissue. In contrast to the permanent synthetic prosthesis which loses strength with time, the mechanical behavior of tissue-engineering grafts should improve with time because of neoligament tissue development and remodelling.…”