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Clinical application
Anterior cruciate ligament (ACL) injury is a frequently occured human body strucure damage and may cause secondary damages to the knees, such as meniscal tears and articular cartilage degeneration, without proper medication treatment. ACL reconstruction is the most promosing technique for ACL injury, which manages to restore the stability of knee. structure. Tradtional ACL restruction uses autografts or allografts which demand a long rehabilitation time and, in most cases, develope donor morbidity in the future. In 1980s, the advancement in chemical and biomaterials industry provides the basis for an alternative method of ACL injuiry-artificial ligament.

The early interests in artificial ligament led to implementation of non-human tissue, such as Proplast ligaments made of Teflon and carbon fibers and Polyflex made of polypropylene. The early animial trails shew unsatisfactory results with high rupture rate. Approved bt FDA in 1986 and widely adopted in clinics later, Gore-Tex cruciate ligament prosthesis demonstrated low rate of mechanical failure but high rate of complications in follow-up. Gore-tex was then abandoned in ACL surgery and Leeds-Keio ligament was then accepted. In the later long term follow-up research, LK ligament demonstrated promising performance at first but still shew high rupture rates and increased degenerative changes compared with their opposite joint in one decade. After it came to the 21st century, LARS ligament became the most popular artificial ligament in the market. LARS ligaments not only provide satisfactory outcomes initiallys but also do not perform differently in at least 2 years. LARS ligaments demonstrate higher stability and lower morbidity rate compared to autograft in the short term research and in the longest long term follow-up research on LARS ligament, a 9-year study, LARS ligament shew a 100% survival rate. The ideal material for artificial ligament has been a long and ongoing dabate. Synthetic ACL crafts always develop creep, fatigue and failure so the demand for synthetic crafts with sufficient supply, satisfactory mechanical properties and low morbidity rate is essentially high. Currently, LARS ligament is the most comparing choice compared to both autografts abd other synthetic crafts.

The sophiscated study of complications associated with artifical ligaments, which are the most controversial issue regarding artificial ligament, was initiated in the 1990s. The complications occur in the 1st dacade are commonly breakage, wear debris, synovitis, recurrent instability, osteolysis and chronic effusions. Complications do not commonly surface right after the surgery or in a relatively short term, and in a few cases, start to show up after the 1st dacade. Follow-up research is required to study the performance of certain synthetic material for artifical ligament and to monitor the health situation of patients. Rupture rates are usually recorded in a certian time period.