A Comparative Analysis of Four Types of Prosthetic Anterior Cruciate Ligament Replacement in the Goat

Abstract

The biological response to, and in vivo mechanical performance of, four artificial anterior cruciate ligament (ACL) replacements available for clinical use, has been examined in the goat over a period of two years. The prostheses used in the study were manufactured from PTFE, Dacron or a composite of Dacron and carbon fibres. None were found to perform adequately both intraosseously and intraarticularly. Ingrowth of tissue was observed around both the PTFE and Dacron fibres in the bone tunnels, this was dependent on the arrangement of the fibres in the outer sheath of the prosthesis. The breaking load for each device immediately post insertion was lower than that of the normal ACL. This load increased for the PTFE and Dacron ligaments at six months, but declined at twelve months, at which time all the devices failed below the level measured for normal ACLs. Two years after insertion all the replacements showed signs of either partial or complete rupture intraarticularly.