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The use of long-term bioresorbable scaffolds for anterior cruciate ligament repair.

The absence of adequate options to restore full knee joint function through anterior cruciate ligament reconstruction prompts the need to develop new ligament replacement strategies. Recent focus within the ligament engineering field has been on the establishment of appropriate anterior cruciate ligament graft design requirements and evaluation methods. A range of biomaterials and graft constructions has been explored in an attempt to identify the optimal ligament replacement. Thorough and standardized evaluation methods are required throughout all phases of development, from initial in vitro bench screening through a large animal in vivo model. The initial positive clinical, gross pathologic, histologic, and mechanical results from a 12-month in vivo goat study demonstrate the potential of bioengineered ligament devices.

Outcomes of Single-Bundle Anterior Cruciate Ligament Reconstruction

Arthroscopically assisted single-bundle reconstruction of the anterior cruciate ligament (ACL) is a reproducible surgical procedure with a high success rate and greater than 90% patient satisfaction. Data on arthroscopically assisted single-bundle ACL reconstruction using the classic bone-patellar tendon-bone autograft, hamstring autograft, as well as allograft tissues indicate that the procedure reliably improves knee stability and patient function. Complications following ACL reconstruction using modern endoscopic techniques are generally mild and uncommon. Graft failure, when noted, occurs in 0% to 6% of patients; 15% to 25% of patients report mild patellofemoral discomfort and/or crepitus. Significant postoperative stiffness is rare, with absolute postoperative range-of-motion measurements averaging 0°to roughly 140°in more than 90% of patients.