ACL Prosthetic Grafts - Pete Thompson 10/10/2000
Prosthetic material 1st used in 1918 (silk) but failed in 3 months. Generally synthetics are more popular outside N. America. They maybe classified as: Augmentation Device (adds strength to biologic graft during revascularisation); Stent (generally stress shield excessively); Scaffold (provides scaffold for soft tissue in-growth); Total Prosthesis (permanent replacement without soft-tissue ingrowths).
Most of the studies published on carbon fibre prostheses are actually animal studies- the final nail in the coffin was one which showed deficient bone fixation rather than studies high-lighting dissemination of carbon particles.
1
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Author
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A.A. Schepsis and J. Greenleaf
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Title
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Prosthetic Materials for Anterior Ligament Reconstruction
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Reference
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Ortho-Rev 1990 Vol.19 (11) 984-991
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Summary
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Review article explaining differences between synthetic materials currently used. LAD has mixed review. Gore-Tex grafts have 34% failure rate and 40-60% complication rate. Lack of long-term follow-up.
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Critique
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Excellent review which is well referenced and worth reading
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2
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Author
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K. Fujikawa, F. Iseki and B>B. Seedhom.
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Title
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Arthroscopy after Anterior Cruciate Reconstruction with the Leeds-Keio Ligament
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Reference
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J.B.J.S. 1989 Vol.71-B 566-570
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Summary
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Arthroscopic follow-up of 42 Leeds-Keio reconstructions showing in-growth of collagen over 18 month period to leave essentially normal looking ACL with histologically mature parallel alignment of collagen.
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Critique
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Prospective study. ? Ethical approval. Benefit to authors!!!
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