Reconstruction of the anterior cruciate ligament with carbon fibres: unsatisfactory results after 8 years

Abstract

A total of 37 patients were operated on for anterior cruciate ligament (ACL) insufficiency between 1980 and 1989 using two types of carbon fibre ligament substitutes. The average age of the population was 23.6 years. The carbon fibre prostheses were covered with either a strip of medial joint capsule or lyophilized dura. Follow-up averaged 8.1 years (range 4-13 years), most of the operations being done from 1983 to 1985. Evaluation included a questionnaire, physical examination, Lysholm scoring, radiographs and cruciometer testing. The operated ACLs were looser than those in the contralateral healthy knees. The Lysholm scoring system gave acceptable results (excellent and good) in 43.5%, fair in 31.4% and poor in 24.1% of cases. Acceptable results provided better stability and muscle strength. During the follow-up there was an evident deterioration in stability as well as in Lysholm score. The results between the two types of ligaments did not become statistically different. Osteoarthrosis increased in all the knees examined radiographically (28/37). The results indicate that the ACL reconstructions using these types of carbon fibre prostheses lead to unacceptable results in the long-term follow-up.

ACL Reconstruction Using Autologous Hamstrings Augmented With the Ligament Augmentation and Reconstruction System Provides Good Clinical Scores, High Levels of Satisfaction and Return to Sport, and a Low Retear Rate at 2 Years

“…While various synthetic materials have been employed, 33 excessive synovitis and high failure rates limited their ongoing use. 26,27,29,36,43,45,63,64 However, further work employing the LARS, made of polyethylene terephthalate, reported that under certain conditions, artificial ACLR could be successful. 32,37 Moreover, in vivo and animal studies have suggested that the LARS may permit tissue in-growth properties, 55,56 which, while not necessarily suitable as an ACL replacement, 56 may provide benefit in augmentation as used in the current study.…”

“…While a recent 10-year longitudinal study 9 demonstrated satisfactory clinical outcomes and failure rates in patients undergoing primary ACLR employing a synthetic ligament and remnant preservation, excessive synovitis and high failure rates have limited their ongoing use in earlier studies. 26,27,29,36,43,45,63,64…”

Carbon‐Based Materials for Articular Tissue Engineering: From Innovative Scaffolding Materials toward Engineered Living Carbon

“…Some previously referenced studies have put forward a suboptimal long-term biocompatibility of carbon fibers for ligament or tendon repair, and discussed potential health risks of carbon nanotubes. [10,77,90,91] The promising biocompatibility of other families, like glassy carbons, graphene, and carbon nanocomposites, still needs to be further characterized and assured before clinical application can be attempted. In general, an adequate route for these evaluations is applying the ISO 10993, by testing cytotoxicity, sensitization, irritation, intracutaneous reactivity, subchronic toxicity, genotoxicity, implantation, and hemocompatibility.…”

Ergebnisse mit Kohlefaserimplantaten 13 Jahre nach Kreuzbandersatzplastik

“…Die Umscheidung sollte zum einen die C-Faser vor der Ruptur bewahren [1,13], darüber hinaus jedoch auch noch die Induktion des Neoligaments fördern [2,13]. Als weiteren Vorteil der Umscheidung sah man auch die Reduktion der mittlerweile bekannten Fremdkörperreaktionen durch den Schutz des Gelenks vor den C-Faserpartikeln an [13].…”

“…Ein Ziel der Kreuzbandersatzplastik ist es, auch das Fortschreiten der Gonathrose aufgrund der Instabilität nach Kreuzbandruptur zu vermeiden. Makisalo wies radiologisch nach, dass dieses Ziel bei der C-Faserimplantation verfehlt wird [13]. Der Grund hierfür ist zum einen in der Insuffizienz des Implantats aber auch in der chronischen Synovitis zu sehen [2,11].…”