E. Manikandan, a 23-year-old software professional from Chennai, has become the first person in Tamil Nadu to receive synthetic ligaments, following a successful arthroscopy surgery at Rela Hospital for a multi-ligament knee injury sustained in a road accident three months ago. Surgeons used artificial ligaments to reconstruct two cruciate ligaments inside the knee.
Initially, surgeons at Rela Hospital stabilised Manikandan’s fractured pelvis with external fixation and repaired other damaged ligaments and nerves in his knee. After a three-month interval, they performed an hour-long arthroscopy procedure using synthetic ligaments imported from the United Kingdom. This procedure successfully reconstructed the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL).
The ACL and PCL are the knee’s primary ligaments, connecting the thigh bones to the lower leg bones. Injuries to two or more of these ligaments, known as multi-ligament knee injuries, are often associated with high-energy trauma like road accidents or sports injuries. These injuries can lead to long-term morbidity, including chronic pain, instability, and impaired mobility.
Ilankumaran Kaliamoorthy, CEO of Rela Hospital, explained that traditional treatments involve using either autografts, which require harvesting ligaments from the patient's own body, or allografts, which use ligaments from cadavers or amputated legs. These methods can result in prolonged rehabilitation and incomplete recovery, affecting the patient’s quality of life and ability to return to normal activities. Synthetic ligaments, however, eliminate many of these shortcomings, offering new hope for patients with multi-ligament injuries.
The arthroscopy procedure was performed by Prakash Ayyadurai, Senior Consultant Arthroscopy & Sports Medicine at Rela Hospital, and his team, with the presence of Ashok S. Gavaskar, Clinical Lead - Orthopaedics and Head of Joint Replacement Services, and Parthasarathy Srinivasan, Senior Consultant - Orthopaedics and Head of Spine Surgery. The surgery was uneventful, and the patient is expected to be discharged within a week. He can resume his routine activities without restrictions, leaving his painful and complex injury behind.
Ayyadurai noted that while arthroscopy surgery is not new, this was the first time the minimally invasive procedure was performed using synthetic ligaments. These ligaments present a viable and preferred alternative to both autografts and allografts. Autografts require additional surgery to harvest the ligament, posing risks of infection and complications, while allografts face availability and regulatory challenges. In contrast, synthetic ligaments are readily available and do not require regulatory approvals, with recovery and rehabilitation time reduced to days instead of weeks or months.
Klaudiusz Kosowski, Medical Director and Chairman of MedPolonia Private Hospital in Poland highlighted that synthetic ligaments, made of strong polythene material, match natural ligaments in strength and durability. Considering that 15-20 per cent of all knee injuries are multi-ligament injuries requiring reconstruction, synthetic ligaments could revolutionise arthroscopy, he added.
