Bone adaptation to a polyester fiber anterior cruciate ligament replacement

A series of polyester fiber ACL implants was studied in ovine stifle joints up to 2 years postimplantation. The implants were linked to the bone-tunnel wall by oriented fibrous tissue. Cross-sections of the tunnels showed bone ingrowth among the implant fibers at 2 years. A human trial of the Apex implant yielded a series of retrievals, some associated with gross bone-tunnel enlargement. There was no evidence of bone ingrowth in the human implants. It was hypothesized that-tunnel enlargement resulted from fretting at the implant-tissue interface in response to cyclic loads in use.