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Synovitis and artificial ligaments.

W Klein1, K U Jensen

  • 1Orthopaedic Clinic, Dusseldorf, Germany.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|January 1, 1992
PubMed
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Dacron prosthetic ligaments for anterior cruciate ligament (ACL) reconstruction led to high complication and reoperation rates, often resulting in degenerative arthritis. While knee stability improved, the procedure caused iatrogenic arthritis, yielding discouraging outcomes.

Area of Science:

  • Orthopedic Surgery
  • Biomaterials Science
  • Sports Medicine

Background:

  • Anterior cruciate ligament (ACL) injuries are common in athletes.
  • Prosthetic ligaments offer a potential alternative to autograft or allograft reconstruction.
  • Dacron prostheses were explored for ACL reconstruction in the 1980s.

Purpose of the Study:

  • To evaluate the long-term outcomes of arthroscopic ACL reconstruction using Dacron prosthetic ligaments.
  • To assess complication rates, reoperation frequency, and functional results.
  • To determine the incidence of iatrogenic arthritis following Dacron ligament implantation.

Main Methods:

  • Prospective follow-up of 57 patients (60 knees) who underwent arthroscopic ACL reconstruction with Dacron prostheses.

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  • Data collection included complication rates, reoperation rates, prosthesis removal, and clinical assessments (Lysholm score, pivot shift, KT-1000 arthrometer).
  • Average follow-up duration was 4.4 years.

    • Main Results:

    • High complication rate (43% at 4.4 years) and reoperation rate (34 reoperations).
    • Prosthesis removal was necessary in 28% of knees due to abrasion, arthritis, and rupture.
    • Significant improvement in Lysholm scores (43 to 82) but persistent instability (58% with 2-3+ pivot shift).

    Conclusions:

    • Arthroscopic ACL reconstruction with Dacron prostheses resulted in a high rate of complications and reoperations.
    • The procedure frequently led to iatrogenic degenerative arthritis and prosthesis failure.
    • Despite initial stability improvements, the long-term results were discouraging due to induced arthritis.