Role of Scaffolds in the Reconstruction of Anterior Cruciate Ligament of Knee-Systematic Review

Abstract

Aim: To analyse the functional outcome after the use of biological/synthetic scaffolds in patients with anterior Cruciate Ligament injuries. Background: Injuries to the anterior cruciate ligament are common. Due to low cell density and poor regenerative capacity, primary surgical repair can lead to failure. There is a critical need for scaffolds that can replace or provide adequate strength and enhance healing potential. The purpose of this paper is to review the basic science and clinical understanding of scaffolds, which are currently used for anterior cruciate ligament reconstruction. Methods: A search was performed using EBSCO Hosted Medline, CINAHL, Cochrane and PubMed using various combinations of the keywords ‘anterior cruciate ligament’, ‘scaffold’, ‘biological scaffold’ and ‘synthetic scaffold’ over the years 1966–2015. The studies that are most relevant to the research question are selected. All articles relevant to the subject were retrieved, and their bibliographies hand searched for further references in the context to biomaterials for anterior cruciate ligament reconstruction. Results: Numerous biomaterials are available as scaffolds for the repair/reconstruction of anterior cruciate ligament injuries. The use of LARS ligament for anterior cruciate ligament injuries are safer and successful when compared to other commercially available scaffolds. Conclusion: Biomaterial for tendon augmentation and/or replacement is an emerging field, which has huge implications in the management of injuries to anterior cruciate ligament. Available studies support the idea that these biomaterials have the ability to provide an alternative for the available techniques, however studies with long term follow-up concentrating on patient safety, effectiveness and cost-benefit analysis is the need of the hour.