Chinese Journal of Tissue Engineering Research ›› 2012, Vol. 16 ›› Issue (51): 9655-9662.doi: 10.3969/j.issn.2095-4344.2012.51.029

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Substitute materials for repair and reconstruction of the knee anterior cruciate ligament

Hu Yan   

  • Online:2012-12-16 Published:2012-12-16

Abstract:

BACKGROUND: The anterior cruciate ligament is the important ligament tissue in the knee joint, which plays an important role in maintaining the stability of the knee joints. Anterior cruciate ligament injury is the most common injury in sports. The anterior cruciate ligament rupture caused knee instability is known as anterior cruciate ligament defect knee, so, if not handled properly, it will greatly affect the athletic ability of the patients, and affect the daily life and work of the patients. With the development of treatment technology and the in-depth understanding of the anterior cruciate ligament, the repairing and reconstruction of the anterior cruciate ligament has attracted more and more attention. As the effects of repairing and reconstruction of anterior cruciate ligament are closely related with the substitute materials, the research on the substitute materials in bio-engineering and organizations materials science is gradually developed.
OBJECTIVE: To in-depth explore the selection of substitute materials according to the diverse characteristics of substitute materials selection of knee anterior cruciate ligament, in order to provide different viewpoints for the selection of the ideal substitute materials for the repairing and construction of anterior cruciate ligament.
METHODS: The anatomical mechanisms, diagnostic mechanism, injury mechanism, injury severity of the anterior cruciate ligament and the performance of magnetic resonance imaging and the characteristics were analyzed, finding that the anterior cruciate ligament was the key structure for maintaining the stability of the knee joint, so the high requirement of the substitute materials after injury was needed. There was a controversial on the selection of substitute materials for anterior cruciate ligament reconstruction. The experimental data of the application of four kinds of substitute materials for anterior cruciate ligament reconstruction, including autologous material, allogenic material, synthetic materials and tissue engineering anterior cruciate ligament were analyzed.
RESULTS AND CONCLUSION: The selection of four kinds of substitute materials for anterior cruciate ligament reconstruction is related with various factors, such as the stability and postoperative complications. Easily obtained and no-immune rejection made the autologous material become the standard treatment method of anterior cruciate ligament reconstruction, but it is restricted due to the shortages of limited donor area and loss of function; allogenic materials has the advantages of extensive source, less trauma and short time under the premise of not adding new trauma, but the remodeling process of allogeneic material is relatively slow, and has to face the immune rejection problems; the mechanical performance and other indicators of the synthetic material are gradually meet the requirement of anterior cruciate ligament reconstruction, but the cost is high and the healing of tendon bone is slow, and there is a controversy of the long-term efficacy of anterior cruciate ligament reconstruction which limit its clinical application; the tissue engineering anterior cruciate ligament has made some progress in some respects, but the uncertainty of life of tissue engineering anterior cruciate ligament is the biggest drawback to its application. The long-term effect of tissue engineering anterior cruciate ligament repairing and reconstruction remains to be further researched and explored.