[Long-term results of arthroscopic implantation of a Trevira prosthesis for replacement of the anterior cruciate ligament].

The present report describes the results of long-term follow-up after arthroscopic replacement of the anterior cruciate ligament with a synthetic ligament made of "Trevira-Hochfest". Over a period of 27 months 88 Trevira ligaments were implanted at the Department for Trauma Surgery of the Krankenhaus der Barmherzigen Brüder in Eisenstadt using the arthroscopic assisted two-drill-hole technique. The overall complication rate found after follow-up for up to seven years was 47.7% (42/88). In 14 patients ligament ruptures occurred within the first 24 months after surgery; a further 8 ruptures were seen in the subsequent years. Including the 12 instable knee joints found at the time of the follow-up, the overall rupture rate seen was 38.6% (34/88). In obvious contrast to reports on comparable synthetic ligaments, the ruptures seen invariably showed smooth rupture surfaces without any fraying. In all of the cases removal of the ruptured ligaments was possible without any problems. It is highly likely that this material-specific characteristic is also responsible for the comparably low incidence of synovitis (18%) with only one of our patients requiring an explantation of the synthetic ligament due to recurrent synovitis. Of the patients with intact Trevira ligaments excellent or good results in the OAK-Score were seen for 76.8% at follow-up after up to seven years. Follow-up stability tests performed in 69 patients showed intact Trevira-ligaments in 57 cases (82.6%). The radiographic findings obtained for the postoperative follow-up for up to seven years failed to show any clinical evidence of the arthrosis-promoting effects of foreign-body synovitis demonstrated in experimental models.