Tendon and ligament prostheses.

The topic of artificial tendons and ligaments for the foot and ankle has been investigated. Close attention has been given to three implants, the Silastic-rod implant, the carbon-fiber implant, and Marlex mesh. A brief historical background was given to the development of the lateral ankle reconstructive procedures and to the development of the individual artificial prostheses. The biologic reactions produced by the implants have been presented. Carbon-fiber implants and Marlex mesh induce a fibrous growth that produces a neotendon or neoligament, depending on their use. Silastic-rod implantation establishes a hollow tube with qualities very similar to the normal tendon sheath. Carbon fiber and Marlex mesh are directly implanted and used as a temporary tendon or ligament. During this time, they act as a scaffold on which the new tendon or ligament is formed. Silastic-rod implants are incorporated into a two-stage tendon-graft procedure. The Silastic rod is used during stage one to develop a new tendon sheath. Placement of an autologous tendon within the newly formed sheath occurs in stage two. Details of the actual procedure have been presented. Any tendon used in the transfer should be of similar strength with similar expansive qualities. These implants have many potential uses in podiatry. They are particularly useful in trauma cases and patients that present with ankle instability. Research pertaining to the development of an ideal suture and anastomosis technique is still needed.