1.Artelon as a Bio-Scaffold to Augment Collateral Ligament Repair after Knee Dislocation
Myers DM ; Hyland S ; Paulini A ; Melaragno A ; Passias BJ ; Taylor BC
Malaysian Orthopaedic Journal 2022;16(No.2):110-118
Introduction: Knee dislocations (KD) have high rates of
multi-ligamentous injury (MLI). Collateral ligaments rupture
in 50-60% of KDs. Traditionally, collateral ligaments have
undergone primary repair, though microscopic healing is not
optimal. Artelon is a degradable, polyurethane urea bioscaffold thought to decrease mechanical forces and promote
healing, motion, and strength. Currently, little evidence
exists regarding its indications or outcomes.
Material and methods: Thirty-two patients with KD and
MLI undergoing collateral ligament repair at a level-I trauma
centre between 2015-2020 were included. Patients age <18,
with ipsilateral fractures or inadequate follow-up were
excluded. The Artelon (AG) and primary ligamentous repair
group (PR) each included 16 patients. Injury and
perioperative variables were evaluated using SPSS® .
Results: Thirty-two KDs were included in 32 patients, with
60% anterior. There were no significant differences between
the two cohorts demographically or with regards to the type
or severity of injury sustained. Meniscal pathology was
addressed in 14 patients in both groups. Thirty-eight percent
of all patients lacked >15° of knee flexion. Only one gross
failure occurred, in the AG. No differences were noted in
infection or re-operation. Lysholm Knee Scale and Tegner
Activity Scale were not significantly different, although
Tegner scores in both cohorts decreased from pre-injury
scores.
Conclusions: In summary, Artelon appears to be safe
without increasing risk for hypersensitivity or infection
when used for collateral ligament augmentation.
Additionally, Artelon appeared to be non-inferior and
statistically equivalent to primary repair in this setting and
may have promise with use in certain types of knee
dislocations.