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Related Experiment Videos

[Augmentation techniques: are they out?]

H Kiefer1, M Richter, G Hehl

  • 1Klinik für Unfall- und Wiederherstellungschirurgie, Lukas-Krankenhaus Bünde.

Zentralblatt Fur Chirurgie
|November 17, 1998
PubMed
Summary

Augmenting anterior cruciate ligament (ACL) repairs with biodegradable cords showed no significant clinical benefit over primary or secondary bone-tendon-bone (BTB) ligament replacement. Functional stability and subjective knee function were comparable to primary replacement in specific cases.

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Journal of materials science. Materials in medicine·2004

Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Sports medicine

Background:

  • Ligament augmentation techniques are explored for improving anterior cruciate ligament (ACL) repair outcomes.
  • Existing literature presents variable results from biomechanical, animal, and clinical studies on augmentation efficacy.
  • Theoretical benefits of augmentation contrast with a lack of significant clinical improvement in many studies.

Purpose of the Study:

  • To evaluate the healing capacity and stability of repaired and augmented ACLs.
  • To compare augmented ACL repair with primary and secondary bone-tendon-bone (BTB) ligament replacement.
  • To assess the impact of augmentation on knee stability and function.

Main Methods:

  • Prospective study involving 200 patients allocated into four groups.

Related Experiment Videos

  • Group 1: Arthroscopic repair and augmentation with PDS II-cord for acute proximal ruptures.
  • Groups 2 & 3: Primary (acute) and secondary (late) BTB ligament replacement.
  • Group 4: Late BTB ligament replacement augmented with PDS II-cord.

    • Main Results:

    • Comparative knee stability observed between the repaired/augmented group (G1) and primary BTB replacement (G2).
    • Decreased stability noted in secondary BTB replacement groups (G3 and G4).
    • Subjective knee function was best in G1 and G2, and worst in G3 and G4; no significant difference in mobility between primary and secondary replacement.

    Conclusions:

    • Augmentation of biologic ligament replacements shows no positive effect on stability, morbidity, complications, or costs.
    • Biodegradable augmentation may successfully reinsert very fresh, marginally ruptured cruciate ligaments.
    • Subjective feeling and functional stability with augmentation can be equal to primary replacement, with no added mobility benefits for secondary replacements.