[Cruciate ligament prostheses. Techniques, results and perspectives]

Area of Science:

• Biomedical Engineering
• Orthopedic Surgery
• Materials Science

Background:

• Artificial ligaments serve diverse roles including augmentation, scaffolds, ingrowth devices, and prostheses in orthopedic applications.
• Augmentation devices depend on host tissue, while other types function as prostheses with inherent limitations.
• Existing artificial ligament technologies face challenges related to limited functional duration and sensitivity to surgical technique.

Purpose of the Study:

• To evaluate the efficacy and limitations of current artificial ligament technologies in clinical practice.
• To identify the primary complications and long-term outcomes associated with artificial ligament implantation.
• To underscore the complexity of knee reconstruction beyond simple ligament replacement.

Main Methods:

• Review of clinical studies and literature on artificial ligament applications.
• Analysis of functional outcomes, failure modes, and complications associated with various artificial ligament types.
• Comparative assessment of augmentation devices versus prosthetic ligament functions.

Main Results:

• Artificial ligaments demonstrate limited functional longevity and are prone to complications such as debris formation, synovitis, and rupture.
• A significant decrease in knee stability is observed in the initial 2-3 years post-implantation.
• Clinical results for prosthetic ligament devices are generally unsatisfactory.

Conclusions:

• Current artificial ligament prostheses have not met clinical expectations, presenting significant challenges.
• The complexity of reconstructing a knee with ligamentous instability is substantial and exceeds the scope of mere ligament replacement.
• Further advancements are needed to overcome the limitations of existing artificial ligament technologies.