Background A ligament advanced reinforcement system (LARS) artificial ligament has been proposed for use in anterior cruciate ligament (ACL) reconstruction, and many reports have shown its success in ACL reconstruction. However, there are great concerns about the potential risk of complications, which might prevent its extensive use. Late failure may occur due to serious complications. Case presentation We report a rare case of serious osteoarthritis that occurred 2 years postoperatively in a 51-year-old man who underwent reconstruction with an LARS artificial ligament. In X-rays, the tibial tunnel was placed too posteriorly. MRI showed that the tibial tunnel was enlarged, and there was a large effusion in the knee joint. The LARS device was rough and worn. Histologically, a large number of fibroblasts and a few multinucleated giant cells infiltrated the graft fibres. Conclusion Our findings remind surgeons that an LARS device should be with great caution in ACL reconstruction.
Objective: To analyze, in a retrospective study, the lateral tunnel position of the graft femur by CT after arthroscopic ACL reconstruction via the anteromedial (AM) approach and the tunnel angle shown on X-ray. Methods and Materials: 60 patients undergoing arthroscopic ACL reconstruction via AM approach with 4 femoral hamstring tendon grafts were investigated from October 2019 to October 2021. Postoperative orthogonal x-rays and computed tomography (CT) scans were obtained, and the position of the femoral tunnel obtained after CT reconstruction was correlated with the Bernard-Hertel grid. The angle of the resulting femoral tunnel on the orthogonal x-ray was analyzed against the CT tunnel position. Results: In the study, the anterior–posterior orientation was forward (P = 0.001) and the high-low orientation was similar (taken as 20%, P = 0.066) or slightly higher (taken as 21%, P = 0.025) compared to the AM beam localization in the two-beam reconstruction. Overall, the femoral tunnel angle on non-weight-bearing orthogonal x-ray was negatively correlated with the anterior–posterior (AP) position of the femoral tunnel centre as shown on CT (P = 0.004, r =−0.368) and positively, but weakly, correlated with the high-low (HL) position (P = 0.049, r = 0.254). Conclusion: Non-weight-bearing orthogonal X-rays only can make approximate predictions about the distribution of anatomical reconstruction, I.D.E.A.L reconstruction.
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