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Improvement of ligament substitutes
Anterior cruciate ligament (ACL) tears are one of the most common knee injuries: 200,000 cases are diagnosed each year in the United States only. The ACL is crucial for stabilizing the knee when turning or planting; and its tear results in knee laxity at the origin of arthritic deterioration of the knee, a long-term consequence observed in 85% of the patients. ACL reconstructive surgery improves patients’ quality of life, with QALY gain of 0.18. In 2010, 35,732 patients were treated surgically in France after ACL tear.

To date, autologous tendon transplants (meaning the tissue used is from the patient’s body) are the most commonly used ligament substitutes, with a success rate over 80%. The remaining 20%, however, show poor results and call for the improvement of ACL replacement, for which many challenges remain. Among these, the improvement of the incorporation and healing of the tendon autograft and the limitation of the morbidity associated with tendon harvesting by using synthetic ligament constitute important research topics for the B2OA.

Osseo-integrated PET (polyethylene terephthalate) fiber bundles
In this context, the B2OA is currently working on: 
(i) A better understanding of the “ligamentization” process of the autograft, by which the transplanted tendon changes to acquire a ligamentous structure; 
(ii) The development of new synthetic ligaments and their transfer from basic research to veterinary clinic; 
(iii) The improvement of the osseo-integration of the tendon autografts and synthetic substitutes. 

Arthroscopic view of an PET artificial ligament in its intra-articular trajectory
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