Anterior cruciate ligament reconstruction with LARS™ artificial ligament results at a mean follow-up of eight years

Abstract

Purpose The aim of this study was to review patients that underwent ACL reconstruction with the LARS™ ligament in the First Orthopaedic Division of Pisa University during the period between January 2003 and December 2005. Methods Twenty-six patients were reviewed with an average follow-up of 95.3 months (7.9 years). The review protocol was articulated in three phases: (1) a subjective evaluation using three grading scales: VAS, KOOS and the Cincinnati knee rating scale, (2) a clinical and objective evaluation, and (3) a biomechanical evaluation of the knee stability. Results A global positive result was obtained in 92.3 % of the patients (16 optimal results and eight good results), with a fast functional recovery and a high knee stability. A global poor result was reported in two cases. In our series we did not record cases of infection or knee synovitis. We recorded only one case of mechanical graft failure. The results obtained from our study are encouraging and similar to those in the literature. Conclusions We conclude that the LARS™ ligament can be considered a suitable option for ACL reconstruction in carefully selected cases, especially for older patients needing a fast functional recovery.

Clinical and functional outcome after anterior cruciate ligament reconstruction using the LARS™ system at a minimum follow-up of 10years

“…Artificial ligaments became highly attractive for orthopaedic surgeons at that time due to the lack of donor side morbidity and the ability of early return to sport activities [2]. Accelerated rehabilitation, immediate knee stability and full weight bearing following surgery were feasible compared to biological grafts [3] thus leading to encouraging results in the short-term [4,5]. Despite the initial enthusiasm, clinical research revealed a high percentage of complications in the long-term such as mechanical failures (prosthetic components breakage, fixation loss), synovial complications (foreign body synovitis), chronic effusions, recurrent instability and early knee osteoarthritis [6,7].…”

“…Although the use of artificial ligaments has been discussed critically in the literature [7,9], LARS™ ligaments (Ligament Advanced Reinforcement System, Surgical Implants and Devices, Arc-sur-Tille, France) has been reported to be a suitable material for ACL reconstruction [3,5,[9][10][11][12]. As if history would repeat itself, clinical results in the long-term are again lacking in the literature to confirm the safety and effectiveness of the LARS™ system as a suitable graft for the reconstruction of the ACL.…”

Application of Knitting Structure Textiles in Medical Areas

“…And the longitudinal fibers are parallel and pre-twisted at 90°. [26] According to the number of longitudinal fibers, the diameter of the ligament has different sizes and they are used for different situations.…”

Synthetic grafts in the treatment of ruptured anterior cruciate ligament of the knee joint

“…47 Also, a follow-up at a mean of 8 years reported by Parchi et al in 2013 showed satisfying results reflected in no postoperative complication occurrence and only one case of LARS rupture. 49 On the other hand, the follow-up of 10 years postoperatively carried out by Tiefenboeck et al (2015) revealed lack of subjective satisfaction in half of patients treated with the use of LARS, thus the authors suggested not to consider the ligament system as a potential graft for primary reconstruction of the ACL and rather treat it as an alternative graft in special cases.…”