Synthetic and allograft anterior cruciate ligament reconstruction

Although still in the early stages of development, the use of synthetics and allografts in ACL surgery appears promising. Two prosthetic ligaments, the Kennedy LAD and Gore-Tex, are FDA approved for limited indications. The Kennedy LAD has been shown to be effective in augmenting an autograft with inherent structural weakness in its central portion. The proposed benefits of using this device with grafts of greater strength are unproved. The Gore-Tex ACL reconstruction allows a rapid initiation of vigorous rehabilitation and return to full activities. However, the complication rate with this procedure appears to be higher than that with autograft reconstruction. The use of allograft for ACL reconstruction also has many potential advantages and short-term clinical trials have shown good results. However, the benefits must be weighed against the possibility of long-term failure and potential spread of infectious disease.