[Biological reaction to alloplastic reinforcement of the anterior cruciate ligament].

Control arthroscopy in usually done 6-12 months after reconstruction of the ACL with ligamentum patellae transplant augmented with LAD using Marshall's technique. During these control arthroscopies the metal implants are removed and a biopsy of the synovial lining was performed in 38 cases. We normally anchor both ends of the LAD to obtain better stability and these anchors are removed after 6-12 months (release of the fixation points). Up to now control arthroscopy has been performed on 97 patients, who had their ACL reinserted and 114 patients, whose ACL were replaced by ligamentum patellae transplant, in both cases augmented with LAD. The control arthroscopy revealed 11 cases of tears of the LAD in case ACL were reinserted and 24 cases of LAD tears in case LAD were replaced by ligamentum patellae transplant. The findings of 38 biopsies of the synovial lining are as follows: In 18 cases LAD tears, in 15 cases foreign body reactions with wear particles and an instance of lymphocytic infiltration of the synovia was seen. In 20 cases arthroscopy was inconspicuous: In 2 cases wear particles were seen and lymphocytic infiltration in a single case. In all cases of LAD tears with foreign body reactions the LAD was removed.