年間 4 号発行
ISSN 印刷: 1050-6934
ISSN オンライン: 1940-4379
Indexed in
Anterior Cruciate Ligament Reconstruction with the Leeds-Keio Artificial Ligament
Get access
要約
The Leeds-Keio (L-K) artificial ligament, developed for knee ligament reconstruction, is made of polyester with a maximum tensile strength of 2200 N. This implant works not only as a ligament but also as a scaffold onto which natural tissue grows from synovium. In an animal experiment, each strand of the L-K ligament was covered with new tissue by 2-3 weeks after anterior cruciate ligament reconstruction. Eight weeks postoperatively, abundant fibrous tissue with extensive vascularity covered the implant, which was still histologically immature. After 16 weeks, vascularization and tissue induction began to subside, and histologic analysis showed dense fibers running longitudinally and parallel. By 36 weeks, the new ligament looked like a natural anterior cruciate ligament, although histologically more cells could be seen than in the natural ligament. This maturation was observed only when the substitute was implanted under good tension. Clinically, the surgical procedure has been improved over the past 10 years, to the current practice in which the tape-in-tube double L-K ligament employs a small piece of autogenous tissue to promote early tissue induction and maturation. Using this practice (n = 135), more than 85% of the patients were satisfied subjectively, objectively, and arthroscopically at the 5-year postoperative FU period. Few patients had joint effusion postoperatively. Sacrifice of autogenous tissue is minimal. The patient can return to activities of daily living within 2 weeks, and more than 50% of them to sports within 10 weeks, and the new ligament is expected to keep its function for a long period as ingrowth completes the structure biologically.
-
McGonagle Dennis, De Bari Cosimo, Arnold Peter, Jones Elena, Lessons from musculoskeletal stem cell research: The key to successful regenerative medicine development, Arthritis & Rheumatism, 56, 3, 2007. Crossref
-
Raïf El Mostafa, Effect of cyclic tensile load on the regulation of the expression of matrix metalloproteases (MMPs -1, -3) and structural components in synovial cells, Journal of Cellular and Molecular Medicine, 12, 6a, 2008. Crossref
-
McGonagle D., Jones E., A potential role for synovial fluid mesenchymal stem cells in ligament regeneration, Rheumatology, 47, 8, 2008. Crossref
-
Jones Elena A., Crawford Aileen, English Anne, Henshaw Karen, Mundy Jenifer, Corscadden Diane, Chapman Tony, Emery Paul, Hatton Paul, McGonagle Dennis, Synovial fluid mesenchymal stem cells in health and early osteoarthritis: Detection and functional evaluation at the single-cell level, Arthritis & Rheumatism, 58, 6, 2008. Crossref
-
Messenger Michael P., Raïf El M., Seedhom Bahaa B., Brookes Steven J., Enamel matrix derivative enhances tissue formation around scaffolds used for tissue engineering of ligaments, Journal of Tissue Engineering and Regenerative Medicine, 4, 2, 2010. Crossref
-
Azangwe G, Aspden RM, Ligament and Tendon, Properties of, in Encyclopedia of Medical Devices and Instrumentation, 2006. Crossref
-
Ghalayini S.R.A., Helm A.T., Bonshahi A.Y., Lavender A., Johnson D.S., Smith R.B., Arthroscopic anterior cruciate ligament surgery: Results of autogenous patellar tendon graft versus the Leeds-Keio synthetic graft, The Knee, 17, 5, 2010. Crossref
-
Fujishiro Takaaki, Nishikawa Tetsuo, Takikawa Satoshi, Saegusa Yasuhiro, Yoshiya Shinichi, Kurosaka Masahiro, Reconstruction of the iliofemoral ligament with an artificial ligament for recurrent anterior dislocation of total hip arthroplasty, The Journal of Arthroplasty, 18, 4, 2003. Crossref
-
Altman Gregory H., Horan Rebecca L., Weitzel Paul, Richmond John C., The Use of Long-term Bioresorbable Scaffolds for Anterior Cruciate Ligament Repair, Journal of the American Academy of Orthopaedic Surgeons, 16, 4, 2008. Crossref
-
Seedhom B B, Luo Z-J, Goldsmith A J, Toyoda T, Lorrison J C, Guardamagna L, In-situ engineering of cartilage repair: a pre-clinical in-vivo exploration of a novel system, Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 221, 5, 2007. Crossref
-
Thomas J M C, Beevers D, Dowson D, Jones M D, King P, Theobald P S, The Bio-Tribological Characteristics of Synthetic Tissue Grafts, Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine, 225, 2, 2011. Crossref
-
Messenger Michael P., Raif El Mustafa, Seedhom Bahaa B., Brookes Steven J., The Potential Use of Enamel Matrix Derivative for In Situ Anterior Cruciate Ligament Tissue Engineering: A Translational In Vitro Investigation, Tissue Engineering, 13, 8, 2007. Crossref
-
Wang Wei-Ming, Ma Xiao-Jun, Huang Shi-Bo, Ren Liu-Bao, Liu Yu-Peng, A comparative study of effect of autograft compared with allograft anterior cruciate ligament reconstruction on expressions of LOXs and MMPs , Bioscience Reports, 37, 2, 2017. Crossref