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Interface and biocompatibility of polyethylene terephthalate knee ligament prostheses A histological and ultrastructural device retrieval analysis in failed synthetic implants used for surgical repair of anterior cruciate ligaments

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Abstract

In a prospective clinical study of 54 patients with acute anterior cruciate ligament instability, 56 artificial ligaments made of polyethylene terephthalate (Trevira hochfest) were implanted to restore knee stability. The average follow-up of these artificial knee ligaments was 40.2 (12–79) months; five implants (10%) had to be explanted due to failure after an average of 17.8 (6–50) months. All explants were examined by histological and ultrastructural methods in a device retrieval analysis. With regard to short- and medium-term artificial ligament failure in the human knee joint, a non-isometric surgical implantation technique, inappropriate strain during rehabilitation and implant fatigue and wear were responsible for ligament failures.

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References

  1. Arnoczky SP, Tarvin GB, Marshall JL (1982) Anterior cruciate ligament replacement using patellar tendon. J Bone Joint Surg [Am] 64:217

    Google Scholar 

  2. Arnoczky SP, Torzilli PA, Warren RF, Allen AA (1988) Biological fixation of ligament prostheses and augmentations. Am J Sports Med 16:106

    Google Scholar 

  3. Bolton CW, Bruchmann B (1985) The Gore-tex expanded polytetrafluorethylene prosthetic ligament: an in vitro and in vivo evaluation. Clin Orthop 196:202

    Google Scholar 

  4. Bosch U, Kasperczyk W (1992) Healing of the patellar tendon autograft after posterior cruciate ligament reconstruction - a process of ligamentization? Am J Sports Med 20:558

    Google Scholar 

  5. Chen EH, Black J (1980) Materials design analysis of the prosthetic anterior cruciate ligament. J Biomed Mater Res 14:567

    Google Scholar 

  6. Claes L, Durselen L, Kiefer H, Mohr W (1987) The combined anterior cruciate and medial collateral ligament replacement by various materials: a comparative animal study. J Biomed Mater Res 21:319

    Google Scholar 

  7. Contzen H (1983) Mechanische Eigenschaften der PolyesterProthesen. In: Burri C, Claes L (eds) Alloplastischer Bandersatz. Aktuelle Probleme in Chirurgie and Orthopädie, Bd 25. Huber, Bern, S 40

    Google Scholar 

  8. Contzen H (1985) Materialtechnische Voraussetzungen and biologische Grundlagen fur den alloplastischen Kniebandersatz. Unfallchirurgie 11:242

    Google Scholar 

  9. Daniel D, Penner DA, Burks RT (1988) Anterior cruciate ligament graft isometry and tensioning. In: Friedman MC, Ferkel RD (eds) Prosthetic ligament reconstruction of the knee. Saunders, Philadelphia, p 17

    Google Scholar 

  10. Durselen L (1990) Biomechanische and mechanische Untersuchungen an Kniegelenksbändern and deren alloplastischem Ersatz. Thesis, University of Ulm

  11. Fischer SP, Ferkel RD (1988) Biomechanics of the knee. In: Friedman MC, Ferkel RD (eds) Prosthetic ligament reconstruction of the knee. Saunders, Philadelphia, p 3

    Google Scholar 

  12. Freudiger SN (1992) Biomechanical considerations. In: Jakob RP, Staubli H-U (eds) The knee and the cruciate ligaments. Springer, Berlin Heidelberg New York, p 505

    Google Scholar 

  13. Gillquist J, Magnus Odensten (1993) Reconstruction of old anterior cruciate ligament tears with a dacron prosthesis - a prospective study. Am J Sports Med 21:358

    Google Scholar 

  14. Hackenbruch W, Hey W, Henche HR (1992) Long-term results following free autogenous patellar ligament reconstruction. In: Jakob RP, Staubli H-U (eds) The knee and the cruciate ligaments. Springer, Berlin Heidelberg New York, p 424

    Google Scholar 

  15. Hassenpflug J, Blauth W, Rose D (1985) Zum Spannungsverhalten von Transplantaten zum Ersatz des vorderen Kreuzbandes. Unfallchirurg 88:151

    Google Scholar 

  16. Johnson RJ, Erikson E, Haggmark T, Pope MH (1984) Five- to ten-year follow-up evaluation after reconstruction of the anterior cruciate ligament. Clin Orthop 183:122

    Google Scholar 

  17. Johnson RJ, Beynnon BD, Nichols CE, Renstrom PA (1992) The treatment of injuries of the anterior cruciate ligament. J Bone Joint Surg [Am] 74:140

    Google Scholar 

  18. Juncker F (1987) Belastbarkeit der Kniebänder aus Trevira hochfest®. Schriftenreihe: Unfallmedizinische Tagungen der Landesverbände der gewerblichen Berufsgenossenschaften. BG U Med 64:217

    Google Scholar 

  19. Kock H-J, Sturmer KM, Letsch R (1991) Biologische Gewebereaktion nach alloplastischem Ersatz des vorderen Kreuzbandes durch PET-Band (Trevira hochfest®). Unfallchirurg 94:594

    Google Scholar 

  20. Kohn D (1990) Arthroscopic evaluation of anterior cruciate ligament reconstruction using a free patellar tendon autograft. Clin Orthop 254:220

    Google Scholar 

  21. Kwasny O, Schabus R, Plenk H Jr (1991) Biologische Reaktion auf alloplastische Verstärkungen des vorderen Kreuzbandes. Aktuel Traumatol 21:159

    Google Scholar 

  22. Letsch R, Sturmer KM, Kock H-J, Schmit-Neuerburg KP (1993) Nahtprotektion des frisch rupturierten vorderen Kreuzbandes durch ein PET-Band (Trevira hochfest®). Unfallchirurg 96:499

    Google Scholar 

  23. Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of scoring scale. Am J Sports Med 10:150

    Google Scholar 

  24. MacNicol MF, Penny ID, Sheppard L (1991) Early results of the Leeds-Keio anterior cruciate replacement. J Bone Joint Surg [Br] 73:377

    Google Scholar 

  25. Mironova SS (1978) Spätresultate der Rekonstruktion des Bandapparates des Kniegelenks mit Lawsan. Zentralbl Chir 103:432

    Google Scholar 

  26. Morrison JB (1969) Function of the knee joint in various activities. J Biomech Eng 4:573

    Google Scholar 

  27. Müller-Mai CM, Gross UM (1991) Histological and ultrastructural observations at the interface of expanded polytetrafluorethylene anterior cruciate ligament implants. J Appl Biomaterials 2:29

    Google Scholar 

  28. Munzinger U (1992) Current status of synthetic ligament reconstruction. In: Jakob RP, Staubli H-U (eds) The knee and the cruciate ligaments. Springer, Berlin Heidelberg New York, p 517

    Google Scholar 

  29. Neyret P, Donell ST, Dejour H (1993) Results of partial meniscectomy related to the state of the anterior cruciate ligament. J Bone Joint Surg [Br] 75:36

    Google Scholar 

  30. Noyes FR, Grood ES (1976) The strength of the anterior cruciate ligament in humans and rhesus monkeys. J Bone Joint Surg [Am] 58:1074

    Google Scholar 

  31. Olson EJ, Kang JD, Fu FH, Georgescu HI, Mason GC, Evans CH (1988) The biomechanical and histological effects of artificial wear particles: in vitro and in vivo studies. Am J Sports Med 16:558

    Google Scholar 

  32. 0'Brian SJ, Warren RF, Pavlov H, Panariello R, Wickiewicz TL (1991) Reconstruction of the chronically insufficient anterior cruciate ligament with the central third of the patellar ligament. J Bone Joint Surg [Am] 73:278

    Google Scholar 

  33. Pattee GA, Friedman MC (1988) A review of autogenous intraarticular reconstruction of the anterior cruciate ligament. In: Friedman MC, Ferkel RD (eds) Prosthetic ligament reconstruction of the knee. Saunders, Philadelphia, p 22

    Google Scholar 

  34. Pattee GA, Snyder SJ (1988) Prosthetic reconstruction of the anterior cruciate ligament: historical overview. In: Friedman MC, Ferkel RD (eds) Prosthetic ligament reconstruction of the knee. Saunders, Philadelphia, p 29

    Google Scholar 

  35. Salamon A, Mayer F, Temes G (1970) Der experimentelle Ersatz des vorderen Kreuzbandes im Kniegelenk durch Transplantate verschiedenen Typs. Bruns Beitr Klin Chir 218:192

    Google Scholar 

  36. Salvi M, Velluti C, Misasi M, Bartolozzi P, Quacci D, Dell Orbo C (1991) Ultrastructure of periprosthetic Dacron knee ligament tissue. Acta Orthop Scand 62:174

    Google Scholar 

  37. Schabus R (1988) Die Bedeutung der Augmentation fur die Rekonstruktion des vorderen Kreuzbandes. Acta Chir Austriaca (Suppl) 76:1

    Google Scholar 

  38. Schepsis AA, Greenleaf J (1990) Prosthetic materials for anterior cruciate ligament reconstruction. Orthop Rev 19:984

    Google Scholar 

  39. Seedhom BB (1992) Reconstruction of the anterior cruciate ligament. Proc Inst Med Eng [H] 206:15

    Google Scholar 

  40. Sowa G, Sowa D, Koebke J (1991) Alloplastischer Ersatz des vorderen Kreuzbandes. Unfallchirurgie 17:316

    Google Scholar 

  41. Tumer IG, Thomas NP (1990) Comparative analysis of four types of synthetic anterior cruciate ligament replacement in the goat: in vivo histological and mechanical findings. Biomaterials 11:321

    Google Scholar 

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Authors and Affiliations

  1. Abteilung für Unfallchirurgie, Universitätsklinikum Gesamthochschule Essen, Hufelandstrasse 55, D-45147, Essen, Germany

    H. -J. Kock, K. M. Stürmer, R. Letsch & K. P. Schmit-Neuerburg

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  1. H. -J. Kock
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  2. K. M. Stürmer
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  3. R. Letsch
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  4. K. P. Schmit-Neuerburg
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Kock, H.J., Stürmer, K.M., Letsch, R. et al. Interface and biocompatibility of polyethylene terephthalate knee ligament prostheses A histological and ultrastructural device retrieval analysis in failed synthetic implants used for surgical repair of anterior cruciate ligaments. Arch Orthop Trauma Surg 114, 1–7 (1994). https://doi.org/10.1007/BF00454727

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  • DOI: https://doi.org/10.1007/BF00454727

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