Cruciate ligament graft material selection

  1, The gold standard for cruciate ligament reconstruction to date is still bone tendon bone. Bone to bone healing is ideal, patellar ligament and cruciate ligament are similar in nature and close in strength, but are dead bones with the possibility of slow healing or non-healing. There are some complications though: anterior patellar pain, patellar tendon contracture, patellar tendonitis, etc. I also did 20 to 30 cases in 01-02, no obvious complications were found, and I personally think there are ways to avoid or ignore them.  2, Allograft ligaments have defects such as freshness, freezing conditions, freezing injury, irradiation injury, rewarming injury, pre-treatment difficulties, spreading disease, not easily accepted by patients, limited sources, etc. The operation is similar to autologous.  3, currently the most popular and the most statistics is autologous N cord muscle. Easy to take, easy to revise, less complications; strength is about 1.5 times. But any way saphenous nerve injury is not uncommon, of course, the impact on the patient is not obvious. Ao Yingfang summarizes more than 85% excellent at home and abroad. In 2008, I studied in Beihang Hospital, where about 20 sets of ligament reconstruction were performed every day, and it has been systematized: positioning to take tendon, trimming tendon, fixing length and diameter, weaving, microscopic cleaning, positioning, tendon pulling, pre-stressing, measuring bone tract, tensioning stress, fixing and other steps including post-operative systematic rehabilitation training after a long time. The training is fully systematized. Uncertainties in the regeneration process of the cruciate ligament graft: laxity rupture, healing to the bone tissue with uncertainties: non-healing, slow healing, elongation during the healing process, etc. It takes three to six months for proprioceptive recovery, early full activity is prone to failure, and there is uncertainty about the patient’s medical compliance in the long-term recovery process.  4. Lastly, artificial ligaments are simple, effective and inelastic. It is designed to imitate the anatomical structure and biomechanical principles of human ligaments. Simple including technology and equipment, can early activity, fast recovery. Operation is also simple. It is nearly three times stronger than a normal cruciate ligament, does not involve healing, and has been shown abroad to grow into the same tissue as normal ligament tissue. The artificial ligament does not need to be taken and trimmed, the instrumentation is simple, it is not allogeneic, it does not damage itself, and it is relatively reliable in human terms. The ligament is just a stable structure, inelastic and creep-free, unlike artificial joints that are subject to wear and tear sooner or later.  5, again, the issue of surgical indications, the primary purpose of orthopedic treatment is functional, the consequence of cross-ligament injury is joint instability, followed by joint wear and tear gradually aggravated by arthritis, instability is equivalent to something less in the joint, any non-surgical symptomatic method is not possible to solve the stability, must restore stability before the normal stress stimulation to restore the joint, otherwise the wear and tear is serious to the extent of joint replacement Only in the second half of life can we change the way we move and try to save. The human body has the ability to continuously repair and regenerate, and restoring stability is the true meaning and significance of joint reconstruction.  To sum up, we must consider and treat the patient in a holistic manner, as opposed to a surgeon’s surgery, which is only an additional means of treatment, not everything. Medicine is to help patients to recover, doctors are mortals with certain knowledge, and patients are equal mortals, and need comprehensive treatment by consultation of various departments. Doctors who are strong in medical knowledge and treat patients who are medically vulnerable should be patient with patients and not ask them to choose on their own, but help them make a choice on the basis of safety and reliability with their conscience.