Synthetics in Anterior Cruciate Ligament Reconstruction: A Review

Gw, Woods

doi:10.1016/s0030-5898(20)30733-1

Cited by 46 publications

(11 citation statements)

References 10 publications

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“…The use of a carbon fiber transplant for the replacement of the lateral ligaments of the ankle 6 has not shown the disadvantages and negative secondary effects that have been shown for the replacement of the cruciate ligaments of the knee. 6,32 Therefore, we included a reconstruction method using a biocompatible ligament graft in our study.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of the Lateral Ligaments: Do the Anatomical Procedures Restore Physiologic Ankle Kinematics?

et al. 2004

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The maintenance of the range of hindfoot motion decreases the risk of osteoarthritis as well as chronic pain or problems for the patient to walk on uneven surface. Therefore, we believe that standard therapy for chronic instability of the ankle should include direct surgical reconstruction of the ligaments. If this direct procedure cannot be performed because of poor quality of the ligaments an alternative anatomical reconstruction procedure should be considered.

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Section: Discussionmentioning

confidence: 99%

Reconstruction of the Lateral Ligaments: Do the Anatomical Procedures Restore Physiologic Ankle Kinematics?

et al. 2004

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“…Current classification systems for synthetic replacements of the ACL include grafts, ligament augmentation devices, or total prosthetics. Grafts (polyethylene, PTFE), typically fixed at both ends, were the initial focus of synthetic ACL replacement and were meant to provide stability to the ACL-deficient-knee until secondary reconstruction procedures gained popularity [13]. Similarly, ligament augmentation devices (polypropylene, polyester) were intended to provide immediate protection for autogenous tissue grafts until revascularization was complete and the ingrown tissue was capable of withstanding local tensile and compressive forces.…”

Section: Prosthetic Beginnings and Past Usementioning

confidence: 99%

“…Fixed at both ends like a graft, the total prosthesis was intended as a permanent ACL replacement without any soft-tissue ingrowth that would allow the patient to begin aggressive rehabilitation immediately as no tissue maturation or revascularization was required. While the implantation of a full-strength ACL replacement generally led to excellent short-term results, longterm efficacy results were poor due to wear and ensuing rupture of the prosthesis [13].…”

Section: Prosthetic Beginnings and Past Usementioning

confidence: 99%

“…Problems associated with the biological incorporation of scaffolds include variability of tissue in-growth, immature degeneration of the implant and insufficient maturation of the host tissue resulting in an inability of the scaffold to withstand inherent mechanical stresses placed on the ACL. Current directions in this area involve the use of tissue engineering focusing on developing a mechanically and biologically functional matrix for the scaffold and the use of in vitro mechanical signals to guide new tissue development [13].…”

Section: Prosthetic Beginnings and Past Usementioning

confidence: 99%

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Various Prosthetic ACL Grafts: A Review of Literature Various Prosthetic ACL Grafts: A Review of Literature

Bernardino¹

2021

J Dise Dis Tre

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Satisfactory prosthetic replacement of the ACL has been a focus of orthopaedic research endeavours for the past thirty years. Desires to provide immediate mobility and strength to the ACL-deficient knee while avoiding the donor site morbidity caused by the commonly used autograft surgical techniques continually drive new research initiatives. Most of the grafts that have been developed to date have failed due to unsatisfactory long-term physiologic and functional performance. Most permanent ACL prostheses are prone to creep, fatigue, and mechanical failure within several years after implantation. Tissue ingrowth scaffolds and ligament augmentation devices require further refinement to provide effective mechanical support while avoiding stress shielding of the host tissue. In view of these factors, prosthetics are not widely used today in ACL reconstruction, and autogenous tissue grafts remain the gold standard used by the majority of surgeons. Perhaps development of resorbable, tissueinducing and cell-seeded biomaterials will improve the long-term biomechanical performance of the reconstructed anterior cruciate ligament. Advances in tissue engineering combined with developments in molecular biology and gene therapy may couple with the rapid gains in computer-assisted surgery to provide improved options for the ACL-deficient knee, with a greater potential to restore its pre-injury state.

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“…Ltd.) to augment a hamstrings autograft [13,16,17], with patient outcomes of those undergoing augmented ACLR better than those undergoing non-augmented ACLR [16]. However, earlier use of synthetic augmentation, including LARS, appeared to present with excessive synovitis and in higher ACL graft failure rates [18][19][20][21][22][23][24][25]. A more recently employed device to augment an ACLR is FiberTape® (Arthrex, Naples, Florida, USA) [8,12,14,26], with a retrospective comparison of outcomes in patients undergoing ACLR with and without suture augmentation with Fiber-Tape® demonstrating improved outcomes with augmentation [14].…”

Section: Introductionmentioning

confidence: 99%

Good clinical scores, no evidence of excessive anterior tibial translation, a high return to sport rate and a low re-injury rate is observed following anterior cruciate ligament reconstruction using autologous hamstrings augmented with suture tape

Ebert

Edwards

Annear

2023

Arch Orthop Trauma Surg

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Introduction Augmented anterior cruciate ligament reconstruction (ACLR) techniques have been proposed to reduce the high reported re-injury rates and low rates of return to sport (RTS). This study reports clinical outcomes, RTS and re-injury rates in patients undergoing ACLR using autologous hamstrings augmented with suture tape. Materials and methods A total of 53 patients were prospectively recruited, undergoing ACLR using hamstrings with suture tape augmentation, combined with a structured rehabilitation programme. Outcomes were collected to 24 months, including patient-reported outcome measures (PROMs), KT-1000 measurements, peak isokinetic knee strength and a four hop test battery. Limb Symmetry Indices (LSIs) were calculated for performance measures, whilst RTS rates, re-tears and re-operations were presented. Results There were no significant side-to-side differences in anterior tibial translation between the operated and non-operated knees at 6 months (p = 0.433), with no increase (p = 0.841) in side-to-side anterior tibial translation from 6 to 24 months. At 24 months, 98.0% of patients demonstrated normal (< 3 mm) or near normal (3–5 mm) side-to-side differences. LSIs for peak knee extensor torque (p < 0.0001) and the single (p = 0.001), triple (p = 0.001) and triple crossover (p < 0.0001) hop tests for distance significantly improved. All PROMs significantly improved (p < 0.0001), with 70.2% and 85.7% of patients actively participating in pivoting sports at 12 and 24 months, respectively. Three patients underwent secondary procedures for meniscal symptoms. One patient suffered an ACL re-tear (17 months), with no further ipsilateral or contralateral injuries. Conclusion ACLR with suture tape augmentation demonstrated no evidence of excessive anterior tibial translation, high-scoring PROMs, sound performance scores, a high rate of RTS and low re-injury rate.

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Synthetics in Anterior Cruciate Ligament Reconstruction: A Review

Cited by 46 publications

References 10 publications

Reconstruction of the Lateral Ligaments: Do the Anatomical Procedures Restore Physiologic Ankle Kinematics?

Reconstruction of the Lateral Ligaments: Do the Anatomical Procedures Restore Physiologic Ankle Kinematics?

Various Prosthetic ACL Grafts: A Review of Literature Various Prosthetic ACL Grafts: A Review of Literature

Good clinical scores, no evidence of excessive anterior tibial translation, a high return to sport rate and a low re-injury rate is observed following anterior cruciate ligament reconstruction using autologous hamstrings augmented with suture tape

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