How is the anterior cruciate ligament treated surgically and the choice of materials?

Surgery should be considered for complete rupture of the ACL, combined with meniscal or other ligament injuries, participation in high sporting levels, and in younger patients. The method of direct suturing after ACL injury is now largely unused, and the main method used now is minimally invasive surgery with arthroscopic reconstruction. There are three types of materials used in reconstruction surgery: 1. Autologous materials (1), tendons of the flexed knee joint: semitendinosus (ST), thin femoral muscle (GT). (2), Tendons of the extended knee joint: patellar ligament with bone blocks at both ends (BTB) and quadriceps tendon with bone blocks at one end. The tendons reconstructed by the method of straightening the knee tendon heal better with the bone, but the area where the tendon is taken has slightly more adverse reactions; the area where the tendon is taken by the method of flexing the knee tendon has less adverse reactions (the main tendon of the flexed knee is the lateral biceps femoris, the semitendinosus and the thin femoral muscle are on the medial side), but the tendon heals slightly worse with the bone and takes longer, and from the long-term follow-up survey, there is no From the long-term follow-up survey, there is no significant difference between the two, so there is a tendency to increase the application of the tendon of the flexed knee joint. 2. Allogeneic materials, i.e., tendons taken from fresh cadavers, are difficult to source and have individual problems of rejection, disease transmission, absorption, and high price. 3.Artificial ligament In the late 1980s, various artificial ligaments were designed for clinical use, but the early ones were gradually eliminated due to defects in structure, material and histocompatibility, leading to synovitis and fatigue fracture of the material. However, in recent years, the LARS artificial ligament with good histocompatible artificial vascular material has been re-recognized and recommended by experts for the following reasons: (1) after 16 years of clinical application, few reports of synovitis and ligament fatigue rupture have been seen; (2) it does not require its own donor area, which can avoid complications at the extraction site, easy arthroscopic operation, short operation time and small trauma; (3) intraoperative preservation of (3) the stump of the ruptured ligament is preserved during the operation, preserving part of the proprioception, and the postoperative recovery is quick; (4) sufficient tensile strength can be obtained intraoperatively, enabling early postoperative activity and quick recovery. It has been used on a large scale in the Chinese medical market at the beginning of this century, and there has been no case of surgical failure due to the ligament itself. Of course, the expensive price is also a problem that cannot be ignored. The procedure is completed by drilling a hole in the femur and tibia for the attachment area of the ACL, and then introducing the woven tendon or ligament into the drilled bone tunnel and fixing it with an internal fixation device at both ends. The operation takes 30 to 60 minutes.