Arthroscopic "second look" at the GORE-TEX ligament.

We performed an arthroscopic "second look" in 21 knees (20 patients) that had arthroscopic implantation of the GORE-TEX prosthesis for chronic ACL insufficiency. Arthroscopy was done on eight knees at the time of screw removal, eight for knee pain, two for giving way, and three for recurrent effusions. The degree of synovial joint reaction, graft synovial ingrowth, and graft rupture was graded. Microscopic examination was carried out on all biopsies of the GORE-TEX ligament. The average patient age was 30 years and the average time interval from original implantation to second look was 11 months. The GORE-TEX was intact in 11 knees, 10% ruptured in 6, and completely ruptured in 4. There was no correlation between number of GORE-TEX strands ruptured and synovial reaction. No particles of the graft were noted in the synovium if the implant was intact, but particles were noted with graft rupture. We conclude that the intact GORE-TEX ligament is an inert substance and does not cause significant joint reaction. Impingement in the intercondylar notch appeared to be the most common cause of graft failure. Further study is critical to determine the natural history of the GORE-TEX ligament and the knees' response to this prosthetic device.