A comparison of acute and chronic anterior cruciate ligament reconstruction using LARS artificial ligaments: a randomized prospective study with a 5-year follow-up

Chen, Jia; Gu, Aiqin; Jiang, Haitao; Zhang, Wenjie; Yu, Xiangrong

doi:10.1007/s00402-014-2108-3

Cited by 38 publications

(45 citation statements)

References 28 publications

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“…According to a review of the recent literature, the failure rate was 4.75% (23/484) in all studies where the mean follow-up was longer than 3 years (Table 3). [9,10,12,14–19] There were 9 cases of graft rupture and 14 cases of recurrent instability. Among these 9 cases, 6 were due to a new trauma, and 1 case was injury in a high-level sport activity.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of anterior cruciate ligament reconstruction using LARS artificial graft with an at least 7-year follow-up

et al. 2017

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The aim of our study was to assess the medium-term clinical outcomes of anterior cruciate ligament (ACL) reconstruction using the Ligament Advanced Reinforcement System (LARS) artificial ligament.A total of 168 patients who underwent arthroscopic ACL reconstruction with the LARS artificial ligament in our department were enrolled in our research. Only 125 met the inclusion/exclusion criteria, and 91 could ultimately be contacted to participate in our research. The mean follow-up was 92 ± 19 months. Physical examinations and a KT-1000 arthrometer were used to evaluate knee laxity. The International Knee Documentation Committee (IKDC) and Lysholm knee scales were evaluated for knee function. The Tegner score was tested for the condition of return to sport. Range of motion (ROM) and the rates of failure and complications were calculated.Among all patients enrolled in the study, the failure rate was 4.4%, and the overall complication rate was 2.2%. Knee laxity measured by the KT-1000 arthrometer was 1.4 ± 1.5 mm, compared with the preoperative value of 5.1 ± 1.3 mm. The Lysholm score improved from a preoperative value of 54.6 ± 14.3 to a postoperative value of 85.4 ± 12.1. The proportion of return to sport was 86.8% (79/91). The postoperative Tegner score was 4.7 ± 1.3, while its value before injury was 5.5 ± 1.0.In this study, ACL reconstruction using the LARS artificial ligament has a good prognosis with a low failure and complication rate at a mean follow-up of 91 months.Abbreviations: ACL = anterior cruciate ligament, BPTB = one-patellar tendon-bone, FDA = Food and Drug Administration, IKDC = the International Knee Documentation Committee, LARS = the Ligament Advanced Reinforcement System, PET = polyethylene terephthalate, ROM = range of motion.

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Section: Discussionmentioning

confidence: 99%

Clinical outcomes of anterior cruciate ligament reconstruction using LARS artificial graft with an at least 7-year follow-up

et al. 2017

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“…The LARS artificial ligament was made of polyethylene terephthalate, divided in two parts (intra-articular part and extra-articular part) [34]. Intra-articular part was composed of longitudinal external rotation fibers without transverse fibers as an imitation of ACL anatomic structure while extra-articular part was weaved by longitudinal and transverse fibers in order to avoid ligament deformation.…”

Section: Discussionmentioning

confidence: 99%

Comparison of artificial graft versus autograft in anterior cruciate ligament reconstruction: a meta-analysis

Jia

Zhang

Cao

et al. 2017

BMC Musculoskelet Disord

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BackgroundCritically evaluation and summarization for the outcomes between autografts and artificial grafts using in anterior cruciate ligament (ACL) reconstruction have not been performed currently. The purpose of this study is to compare the clinical outcomes between artificial ligaments and autografts at a short- to mid-term follow-up.MethodsA computerized search of the databases was conducted including Medline, Embase, and the Cochrane library. Only prospective or retrospective comparative studies with a minimum 2-year follow-up and a minimum sample size of 15 for each group were considered for inclusion. Two independent reviewers performed data extraction and methodological quality assessment. A Mantel-Haenszel analysis was used for pooling of results. Sensitivity analysis was performed in order to maintain the stability of results.ResultsSeven studies were included in this study. The total sample size was 403 (autograft group: 206 patients; synthetic graft group: 197 patients). Four studies were randomized controlled trials. Two studies were retrospective comparative studies and one study was non-randomized prospective comparative study. In terms of instrumented laxity, patient-oriented outcomes and complications, no significant difference was occurred between new artificial ligaments and autografts. But the results of IKDC grades and instrumented laxity were worsen in early artificial ligaments compared to autografts.ConclusionsThe outcomes of new generation of artificial ligaments are similar to autografts at a short- to mid-term follow-up. However, the early artificial ligaments are not suggested for ACL reconstruction compared to autografts.

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“…This is less than the pooled results of 1.7 mm reported in a meta-analyses of autograft ACLRs by Ardern et al 5 and comparable to the 1.2- to 2.38-mm side-to-side differences reported in previous LARS cohorts. 7,26,31,33 Increased translation with a KT-1000 arthrometer has been associated with anterior-to-posterior (AP) joint laxity more so than rotatory instability, and both are considered important for coupled motion of the knee. 10 Janssen et al 18 observed a significant relationship between pivot-shift laxity (grades 2 and 3) and reduced activity levels, so it is plausible that rotatory laxity might be a more crucial factor in determining higher level sports participation than purely AP joint laxity.…”

Section: Discussionmentioning

confidence: 99%

An Ecological Study of Anterior Cruciate Ligament Reconstruction, Part 1

McGrath

Waddington

Scarvell

et al. 2016

Orthopaedic Journal of Sports Medicine

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Background:Additional high-quality prospective studies are needed to better define the objective criteria used in relation to return-to-sport decisions after synthetic (ligament advanced reinforcement system [LARS]) and autograft (hamstring tendon [2ST/2GR]) anterior cruciate ligament (ACL) reconstruction in active populations.Purpose:To prospectively investigate and describe the recovery of objective clinical outcomes after autograft (2ST/2GR) and synthetic (LARS) ACL reconstructions, as well as to investigate the relationship between these clinimetric test outcomes and return-to-sport activity (Tegner activity scale [TAS] score) at 12 and 24 months postoperatively.Study Design:Case series; Level of evidence, 4.Methods:A total of 64 patients who underwent ACL reconstruction (32 LARS, 32 2ST/2GR autograft) and 32 healthy reference participants were assessed for joint laxity (KT-1000 arthrometer), clinical outcome (2000 International Knee Documentation Committee [IKDC] knee examination), and activity (TAS score) preoperatively and at 12, 16, 20, and 24 weeks and 12 and 24 months postoperatively.Results:There was no significant correlation observed between clinical results using the 2000 IKDC knee examination and TAS score at 24 months (r s = 0.188, P = .137), nor were results for side-to-side difference (r s = 0.030, P = .814) or absolute KT-1000 arthrometer laxity of the surgical leg at 24 months postoperatively (r s = 0.076, P = .553) correlated with return-to-sport activity. Nonetheless, return-to-sport rates within the surgical cohort were 81% at 12 months and 83% at 24 months, respectively. No statistically significant differences were observed between physiological laxity of the uninjured knee within the surgical group compared with healthy knees within the reference group (P = .522).Conclusion:The results indicate that although relatively high levels of return-to-sport outcomes were achieved at 24 months compared with those previously reported in the literature, correlations between objective clinical tests and return-to-sport outcomes may not occur. Clinical outcome measures may provide suitable baseline information; however, the results of this study suggest that clinicians may need to place greater emphasis on other outcome measures when seeking to objectively promote safe return to sport.

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A comparison of acute and chronic anterior cruciate ligament reconstruction using LARS artificial ligaments: a randomized prospective study with a 5-year follow-up

Abstract: These results suggest that earlier ACL reconstruction using a LARS artificial ligament may provide an advantage in the treatment and rehabilitation of ACL rupture.

Cited by 38 publications

References 28 publications

Clinical outcomes of anterior cruciate ligament reconstruction using LARS artificial graft with an at least 7-year follow-up

Clinical outcomes of anterior cruciate ligament reconstruction using LARS artificial graft with an at least 7-year follow-up

Comparison of artificial graft versus autograft in anterior cruciate ligament reconstruction: a meta-analysis

An Ecological Study of Anterior Cruciate Ligament Reconstruction, Part 1

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