Biomechanical Outcomes Following ACL Reconstruction With Textile-Based Solutions
Aim
To assess the biomechanical and functional outcomes following treatment with novel textile-based solutions for surgery.
Background
The number of ACL injuries is increasing in the UK from around 75 per 100000 in 2006 to 160 per 100000 in 2016. The outcome from ACLR remains uncertain in terms of functional performance, return to sport and most importantly development of osteoarthritis. Estimated lifetime risk of symptomatic knee OA is 34% for ACL injury cohort compared to 14% in non-injured and lifetime risk of TKR ranges from 6% in the no injury cohort to 22% for the ACL injury group. Currently surgeons have the impression artificial grafts are inferior to native hamstrings tendon for ACL reconstruction. This is due to previous case series on older types of synthetic graft that had higher rates of re-rupture and joint inflammation. Newer grafts such as the JewelACL have been used thousands of times and have low rates of re-rupture and inflammation, but we do not have high level evidence of this such as randomised clinical trials to convince surgeons of the progress made in this technology. Due to cost effectiveness, we do not expect artificial hybrid grafts to become 1st line choice in all surgeons practice but clear indications in the future could be when hamstrings cannot be harvested due to scar tissue. We also feel it could be used in paid athletes, where they need to return to work as soon as possible. However, it is not known whether an individual will return to sporting activities quicker. The functional performance data collected may help to show a quicker return to sport performance in patients also. This data has never been produced before. Artificial grafts are the next step in the future of sports surgery, and we need to start progressing towards scaffolds that can allow stem cell growth for ligament reconstruction. This would be the first step in doing that.
Funding:
The project is an icase PhD funded by Xiros Ltd
Team:
Dr Bahaa Seedhom
Mr Neil Jain