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Author Topic: synthetic ligaments  (Read 1142 times)

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Offline kscope09

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synthetic ligaments
« on: January 25, 2010, 05:18:36 PM »
I once met someone who told me he had carbon fibre ligaments in his knee and was wondering sicen I may ave to have an acl repair one day, if anyone knows anything about them.  Are they better than real ones?  Are they used when parts have a;ready been harvested and used in reconstuction?  Are they liable to break or be rejected?  Also, whioch OS's use them.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Kaputt_Knee

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Re: synthetic ligaments
« Reply #1 on: January 25, 2010, 05:53:53 PM »
A variety of artificial fibres were used in the 80s and early 90s without a great deal of success.

I had two different types of artificial fibre ligament used to replace the ACL in my right knee. They both failed within a year of placement and the third attempt the used my patella tendon to harvest a graft from. I consider myself lucky that mine both failed so early as people with carbon fibre grafts have had problems with them degrading over time and poisoning the body.

There is a newer artificial ligament of sorts called a LARS graft. This is not a replacement ligament per se as far as I understand it, more of a scaffold which collagen fibres use to build a ligament-like structure on. There is a huge controversy about this type of graft, not only here but also in the orthopaedic world in general.

The accepted gold standard is as far as I know, the patella tendon graft. Whether taken from the same leg or the uninjured one (a contra-lateral graft) is a question of the surgeon's personal preference. The hamstring tendons are also used (semitendinosis and gracilias tendons most frequently) and are the frequent choice for older and/or less athletic patients. Less commonly grafts are taken from your quadriceps tendon. All of these are called autografts as they are taken from your body to be used in your body.

Allografts have come into fashion more recently due to vast improvements in the sterilization and disease transmission prevention pre-treatment of donor tissue. The advantage of an allograft is that there is no secondary trauma from the harvest site, so you are only rehabbing one trauma. Typically cadaver achilles tendon is used for ACL replacements I believe. I'm not sure if other donor tendon tissue is used. As there is little or no blood supply, the risk of cross infection or rejection is minimal. Allografts are commonly used in the USA and to an extent in the UK. They are not so frequently used in mainland Europe as far as I know due to different rules regarding the use of donated tissue. Here in Germany they are rarely if ever used for some unknown reason.

Personally I think it is better to have your own living tissue transplanted within your body if you can. My own experience with artificial ligaments leaves me sceptical about their long term use and their inherent dangers. My right knee has had a patella tendon graft in it since June 1992 and I've been skiing, playing field and indoor hockey, volleyball and squash since I was released to return to sports. OK I don't like kneeling on that knee, but it is in the long term a small price to have paid for a return to my sports.

Just my 2p worth!

Sue  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline kscope09

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Re: synthetic ligaments
« Reply #2 on: January 25, 2010, 06:41:09 PM »
Thanks for the reply.  I think I'' be asking a lot of acl questions for a bit.
Feb 08 Inurred right knee
18 months of physio, knee tracking but knee still painful
Aug 09 Scope - Small tear in acl, fragment found in postereo-lateral compartment, suprapatella and lateral plica and small defect in mfc.
May 10 Right knee feeling better but left knee causing trouble as a result o

Offline Kaputt_Knee

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  • [Ed: Sue sadly passed away in 2016]
Re: synthetic ligaments
« Reply #3 on: January 26, 2010, 06:25:57 AM »
Why not save yourself and everyone else time by starting with the Information Hub. There is a huge section there on all aspects of ACL reconstructions and the ensuing rehab. There is an excellent summary and explanation of the post-op physiotherapy there as well.

There are as many different rehab protocols as there are surgeons and patients. Read some of the post-op diaries to see what I mean.

Knee-will-be-great, Rob_W, Feeny, Macker, among others took time to write really informative diaries. They are to be found in the Cruciates section I believe, not the Post-Op diary section. Whilst there are a hell of a lot of these in the Post-Op section very few, to be brutally honest, are actually interesting to someone coming at this new. Some are downright off-putting, others just very long boring lists of exercises or worse still, whinging on about nothing relevant.

As I said, I've been through this 5 times now and even with the same surgeon (twice), I have not followed the same post-op protocol once. There is some commonality but the exact whys, whens and what fors are decided upon by your surgeon, when and if they operate. Another factor in the equation is whether you have any other work done at the same time, e.g a meniscus trim or suture, ACI, etc.

Sue  ;)
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee















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