Anterior cruciate ligament reconstruction with synthetic grafts. A review of literature.
Anterior cruciate ligament (ACL) rupture, one of the most common knee injuries in sports, results in anteroposterior laxity, which often leads to an unstable knee. Traditional ACL reconstruction is performed with autograft; disadvantages of this technique are donor site morbidity and a long rehabilitation period. In the 1980s, artificial ligaments became an attractive alternative to biological grafts. The initial enthusiasm surrounding their introduction stemmed from their lack of donor morbidity, their abundant supply and significant strength, immediate loading and reduced postoperative rehabilitation. Synthetic grafts made of different materials such as carbon fibers, polypropylene, Dacron and polyester have been utilised either as a prosthesis or as an augmentation for a biological ACL graft substitute. Nevertheless, every material presented serious drawbacks: cross-infections, immunological responses, breakage, debris dispersion leading to synovitis, chronic effusions, recurrent instability and knee osteoarthritis. Recently, a resurgence of interest in the use of synthetic prostheses has occurred and studies regarding new artificial grafts have been reported. Although many experimental studies have been made and much effort has been put forth, currently no ideal prosthesis mimicking natural human tissue has been found.
Scuola di Specializzazione in Ortopedia e Traumatologia, Università degli Studi di Milano, Milano, Italy. clegnan@alice.it
Claudio
C
Legnani
Alberto
A
Ventura
Clara
C
Terzaghi
Enrico
E
Borgo
Walter
W
Albisetti
D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001672:Biocompatible Materials; D004548:Elasticity; D019544:Equipment Failure Analysis; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D007595:Joint Prosthesis; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint / Q000601:surgery*; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D012421:Rupture; D013718:Tensile Strength
D001672:Biocompatible Materials