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Zaffagnini S, Grassi A, Marcheggiani Muccioli GM, et al. Anterior cruciate ligament reconstruction with a novel porcine xenograft: the initial Italian experience. Joints. 2015;3(2):85-90doi: 10.11138/jts/2015.3.2.085.
Zaffagnini, S., Grassi, A., Marcheggiani Muccioli, G. M., Roberti Di Sarsina, T., Raggi, F., Benzi, A., & Marcacci, M. (2015). Anterior cruciate ligament reconstruction with a novel porcine xenograft: the initial Italian experience. Joints, 3(2), 85-90. https://doi.org/10.11138/jts/2015.3.2.085
Zaffagnini, Stefano, et al. "Anterior cruciate ligament reconstruction with a novel porcine xenograft: the initial Italian experience." Joints vol. 3,2 (2015): 85-90. doi: https://doi.org/10.11138/jts/2015.3.2.085
Zaffagnini S, Grassi A, Marcheggiani Muccioli GM, Roberti Di Sarsina T, Raggi F, Benzi A, Marcacci M. Anterior cruciate ligament reconstruction with a novel porcine xenograft: the initial Italian experience. Joints. 2015 Nov 03;3(2):85-90. doi: 10.11138/jts/2015.3.2.085. eCollection 2015. PMID: 26605257; PMCID: PMC4634810.
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Joints. 2015 Nov 03;3(2):85-90. doi: 10.11138/jts/2015.3.2.085. eCollection 2015.

Anterior cruciate ligament reconstruction with a novel porcine xenograft: the initial Italian experience.

Joints

Stefano Zaffagnini, Alberto Grassi, Giulio Maria Marcheggiani Muccioli, Tommaso Roberti Di Sarsina, Federico Raggi, Andrea Benzi, Maurilio Marcacci

Affiliations

  1. The II Orthopaedic and Traumatology Clinic, Biomechanics Laboratory and Technological Innovation, Rizzoli Orthopaedic Institute, Bologna, Italy.

PMID: 26605257 PMCID: PMC4634810 DOI: 10.11138/jts/2015.3.2.085

Abstract

At the current state of the art in anterior cruciate ligament (ACL) reconstruction, multiple techniques have been presented but none has given clearly defined and improved results. One of the main issues concerns the choice of graft. The concept of using xenograft tissue, defined as a graft tissue from one species and destined for implantation in an unlike species, was introduced in order to try to overcome the mechanical and biological concerns associated with synthetic materials and the safety and quality concerns and availability problems of allograft tissue. Xenograft tissue carries the risk of producing an immunological reaction. In order to try to overcome or attenuate the immune response against porcine xenograft tissue, the Z-Process® (Aperion Biologics Inc, San Antonio, Texas, USA) has been developed and used to produce the Z-Lig® family of devices for ACL reconstruction procedures. Z-Lig® is a tendon graft with or without bone blocks, sourced from animal tissue in a manner consistent with what has normally been sourced from human tissue, and processed to overcome anti-Gal-mediated rejection and to attenuate other immunological recognition in humans. All this while ensuring sterility, viral inactivation and preservation of mechanical proprieties appropriate for an ACL reconstruction device. The Z-Lig® device has been tested in skeletally mature monkeys and given interesting and promising results from the preclinical performance and safety profile point of view. On this basis, it was possible to proceed with the first clinical trial involving humans, which gave similar encouraging results. The Z-Lig® device has also been implanted in Italy at the Rizzoli Orthopaedic Institute in Bologna, as a part of international multicenter prospective randomized blinded controlled study aimed at comparing xenograft with allograft tissue.

Keywords: Z-Lig; anterior cruciate ligament; knee; reconstruction; xenograft

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