Development of the Apex polyester fibre cruciate ligament implant.

This paper describes the work done in developing the Apex polyester fibre cruciate ligament implant. A series of animal experiments showed that the material was the basis for good collagenous tissue ingrowth at the calcaneal tendon and within the knee joint. The rate of increase of strength of ingrowth at the calcaneal tendon was investigated. The slow maturation led to the development of a stainless steel screw and grommet anchorage system, which was also tested in vitro. A long-term animal study of the clinical implant and anchor system showed the implant fibres spaced apart by prolific ingrowth, while no implant particles were found, and there was no evidence of synovitis. The tissue reactions in human use have been found to be the same as in the animals, while ultrastructural study of retrieved specimens has given evidence of long-term collagen maturation.