Complications with synthetic ligaments

There is also abrasion of textile structure, which can be divided into two types. The first and more important one is observed as desquamation or surface peeling and flattening of the fibers. This is frequent around the femoral condyle in the over the top technique and out of the tibial osseous tunnel in the intra-articular zone, where there is contact between yarns and bone. Its level of severity depends on the type of weave the tighter the weave, the more abrasion is observed. Poddevin et al. found that this is the main reason for prosthesis failure. To prevent this, some models added protection near these points and surgeons were told to smoothen the osteo-cartilagenous edges of tunnels.  

The second mechanism is intra-articular abrasion in torsion and flexion at the yam-yam interface. This develops after thousands of cycles. Fatigue of the implant leads to axial breaking and fibers fraying. Every structure of textile, especially the more tightly woven ones, is sensitive to this type of failure. The flattened fibers observed could be explained by previous manufacturing processes such as texturizing and heat setting in addition to compressive forces. 

Meanwhile, Olson et al., with a rabbit model, tried to explain the role of the artificial ligament in the pathogenesis of osteoarthritis, well known to be a wear mechanism. The wear particles induce the production of significant levels of neutral proteinases (coUagenases and gelatinases) by synovial cells and chondrocytes activating factors. The substrate of those enzymes is actually the molecular architecture of the articular cartilage. Consequently, 

21 Macroscopic particles found in the knee joint of explanted prosthesis following failure. 

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