Stručni rad
20 YEARS FOLLOW-UP OF GORE-TEX POSTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Tomislav Smoljanović
Alan Ivković
Igor Borić
Sven Seiwert
Miroslav Hašpl
Marko Pećina
Sažetak
Twenty years ago the Gore-Tex expanded
polytetrafluoroethylene (PTFE) prosthetic ligament was
used as feasible salvage procedure in patients with failed,
multiply operated knees, or knees with gross instability.
At the Department of Orthopaedic Surgery we
operated 13 patients and replaced the posterior cruciate
ligament (PCL) with the Gore-Tex prosthetic ligament.
Recently we had opportunity to evaluate clinical,
arthroscopic, magnetic resonance imagining (MRI) and
patohystologic (PH) findings in patient F. K. twenty years
after the reconstruction.
Due to osteoarthritic changes arthroscopic toilette of
the knee was performed. On that occasion arthroscopic
evaluation and biopsies for microscopic examination
were carried out. MRI performed prior to arthroscopy
revealed tidy continuity and volume of PCL with
advanced arthritic changes of knee. MRI findings were
consistent to clinical findings of good knee stability.
Arthroscopy revealed the Gore-Tex prosthetic ligament
completely coated with thicken synovial membrane i.e.
fibrosis. Partial removal of the synovial membrane
showed continuity of characteristic PTFE strands. The
continuity of PCL was established by the probe. After that,
few pieces of synovial membrane from sheath of PCL and
from other parts of synovial membrane of the knee were
taken. One PTFP strand of artificial PCL was collected as
well. Patohystological findings clearly excluded
inflammatory reaction in synovial membrane of the knee.
Furthermore, synovial membrane of Gore-Tex prosthetic
ligament sheath was found to contain mature fibrotic
tissue with multinuclear giant cells and fragments of
foreign polarizing material.
This case report demonstrated good biocompatibility
and good knee stability twenty years after
replacement of the PCL with the Gore-Tex prosthetic
ligament in patient with gross instability. It is interesting
to mention that there was no deterioration of PTFE
strands.
Ključne riječi
Hrčak ID:
14354
URI
Datum izdavanja:
1.7.2007.
Posjeta: 3.579 *