To What Degree is Spider Silk a Better Alternative to a Conventional Graft in Ligament Reconstruction Surgery?

The purpose of this review is to evaluate synthetic spider silk as a potential ligament in anterior cruciate ligament (ACL) reconstruction surgery. Synthetic spider silk, produced using ion-doped and twisted hydrogel fibers, has high capabilities in tensile strength, damping capacity, toughness, stretchability, and Young’s modulus, along with biocompatible properties. It surpasses the commonly used bone-tendon-bone (BTB) graft in tensile strength and stiffness, and the synthetic ligament augmentation reconstruction system (LARS) graft in tensile strength. Clinical trials are needed to fully assess the synthetic spider silk’s viability as a reliable graft in ACL reconstruction. The lack of data on biomechanical properties is apparent in the current literature surrounding ACL grafts. Further research and trials need to be done on varying biomechanical properties (Stretchability, damping capacity, toughness, stiffness) in order to determine the best graft for ACL reconstruction surgery.