Early experience with the GORE-TEX polytetrafluoroethylene anterior cruciate ligament prosthesis

A prospective study of 41 patients with acute and chronic ACL deficiency underwent reconstruction with the GORE-TEX polytetrafluoroethylene (PTFE) ACL prosthesis beginning in November 1983. Thirty-nine patients who were at least 2 years from their surgical procedure were available for follow-up evaluation, which included subjective questionnaire, clinical examination, and instrumented ligamentous laxity tests. Eight patients had an acute injury to the ACL and 31 patients had chronic ACL insufficiency for which reconstruction was performed. Thirty-four patients had satisfactory results, allowing full return to activity with no appreciable symptomatology. Of the remaining five patients, four had a complete rupture of the prosthesis. The average knee arthrometric measurement improved from a 5.4 mm left/right difference preoperatively to a 2.0 mm left/right difference at 2 year followup. Nine patients had postoperative complications of one or more atraumatic episodes of a sterile effusion. Six patients had recurrent effusions; in five, arthroscopy revealed partial tears of less than one-third of the prosthesis. Three patients who had recurrent effusions had PTFE particles in their synovial biopsies. One patient had an immediate postoperative infection and to data has had salvage of the prosthesis and currently has a stable knee with full return to activities. Based on the early results of this study, the GORE-TEX PTFE ACL prosthesis provided a satisfactory method of reconstruction for ACL deficient knees. Based on the evaluation used, 87% of the patients had satisfactory results. Problems associated with use of this prosthesis include partial or complete tears of the prosthesis and sterile effusions, possibly due to synovial irritation from the PTFE particles.(ABSTRACT TRUNCATED AT 250 WORDS)