Prosthetic anterior cruciate ligament.

1. All synthetic anterior cruciate ligaments can be divided into three broad categories--permanent, stent, and ingrowth. 2. Theoretical advantages (e.g., potential increased strength, decreased harvest morbidity, time to return to sport, ease of insertion, ease of revision) warrant further attempts to develop synthetic ACLs. 3. Permanent ACLs require 5-year follow-up. Gore-Tex I had 85% to 90% good to excellent results at 2 years. 4. Acceptable failure rates for permanent prosthesis (5 years? 10 years?) should be discussed. 5. Gore-Tex II will represent a significant improvement to Gore-Tex I (increased abrasion resistance). 6. Prosthetic debris and effusions should continue to be analyzed carefully. Dr. Freddie Fu's protocol for retrieval and analysis should be accepted and standardized. 7. LAD. Careful analysis of the control group in U.S. Series II should enable us to determine the "true" contribution of this augmentation device. 8. Leeds-Keio. If biomechanically significant intra-articular tissue is stimulated, this is a potentially attractive prosthetic concept. U.S. clinical studies will start in 1990. 9. Stryker-Dacron. This device appears to have a failure rate similar to that of Gore-Tex I. 10. Six new prosthetic devices are currently under evaluation by the FDA and are in phases I through V.