Synthetic ligaments for ACL reconstruction

Abstract

The early experience with synthetic ligaments for ACL reconstruction was disappointing. A variety of ligaments made from various substances including carbon fiber, polyester, polytetrafluoroethylene, and polypropylene all resulted in similar problems - synovitis, foreign body reaction, graft rupture, and osteolysis. As a result, they were all ultimately withdrawn from the market. The Ligament Augmentation Reinforcement System (LARS) is made from polyethylene terephthalate and has been used sporadically over the past two decades. It has been reported to have less problems with synovitis but clinical outcomes remain variable. The LARS device has been used extensively in China with apparent success, particularly in older patients. Areas of research interest include the use of alternative materials, various biological coatings, and alternative fixation methods.