Histopathological features of failed prosthetic Leeds-Keio anterior cruciate ligaments

Artificial ligaments such as the Leeds-Keio ligament are inserted into knee joints to treat cruciate ligament trauma. Three cases of prosthetic ligament failure are reported, showing foreign body granulomatous inflammation around implanted fibres, together with abundant fibre particles within giant cells. It is suggested that intra-operative fibre fragmentation can produce a sufficient quantity of dendritic particles to elicit a granulomatous reaction, which can ultimately lead to ligament instability and failure.