Assisted reproduction of the anterior cruciate ligament.

Abstract

This article describes a technique for anterior cruciate ligament (ACL) repair using a synthetic braided ligament made of 75% degradable polyglycolic acid filaments and 25% nondegradable, 6.5-mm Dacron thread, wrapped in a free synovial graft. In a prospective study of 70 consecutive patients, this technique (experimental group) was compared to a standard bone-patellar tendon-bone autograft technique (autograft group). All of the patients improved after surgery. There were no surgical complications, and all of the patients returned to full activity without pain or instability. After mean follow-up of 12 years (range, 8-19 years), patients in the experimental group functioned well and statistically better than patients in the autograft group using International Knee Documentation Committee, Knee Injury Osteoarthritis Outcome Score, and Lysholm evaluation measurement tools. These results suggest a partially biodegradable replacement ligament prosthesis protected by a synovial wrap can result in a functionally stable knee.