Arthroscopic Anterior Cruciate Ligament Reconstruction With Lars Artificial Ligament: An 8–15-Year Follow-Up

Abstract

The aim of this study was to evaluate the clinical results of anterior cruciate ligament (ACL) reconstruction with an artificial ligament of the Ligament Augmentation and Reconstruction System (LARS) via an 8–15-year follow-up. Between January 1996 and January 2003, 38 patients received arthroscopic anterior cruciate reconstruction with the LARS artificial ligament at the Show Chwan Memorial Hospital, Changhua, Taiwan. Among them, 28 cases were included in this study. Excluding two failure cases, 26 cases were involved in the statistical analysis of various clinical assessments. The mean follow-up period after reconstruction was 11.4 ± 1.9 years. Assessment of clinical results included physical examination, magnetic resonance imaging, radiography, KT-1000 arthrometer test for knee stability, range of motion measurement, Lysholm score, and Tegner scale activity evaluations. The outcomes showed that among these 28 follow-up patients, there were two failure cases. The survival rate of LARS ligament reconstruction in this long-term follow-up was 92.9%. Among the 26 clinical assessed cases, the stability of the knee joint was improved as the anterior translation displacement measured by arthrometer reduced from 7.0 ± 3.1 mm (range: 4–17 mm) pre-operatively to 1.7 ± 1.7 mm (range: 0–6 mm) post-operatively. The Lysholm score improved from 39.7 ± 11.5 pre-operatively to 85.9 ± 19.6 post-operatively. Tegner activity scale improved from 3.2 ± 1.5 pre-operatively to 5.4 ± 2.4 post-operatively. All three improvements have statistic significance as the p-values were less than 0.05. In conclusion, ruptured ACL reconstruction with LARS artificial ligament has a survival rate of 92.9% and complication rate of 28.6% in this 8–15-year follow-up.

Long-Term Outcomes of Anterior Cruciate Ligament Reconstruction Using Either Synthetics With Remnant Preservation or Hamstring Autografts: A 10-Year Longitudinal Study

“…Grafts were ruptured in 1 patient and abraded in the other, and the position of the femoral tunnel was not ideal in both patients. Wang et al 56 also reported 2 cases of synovitis in their long-term follow-up. In the present study, synovitis was observed in 1 patient with synthetics, secondary to a graft rupture.…”

“…In the literature, these synthetics, claimed as new-generation devices by manufacturers and clinical believers, showed satisfactory shortterm and midterm outcomes, 18,20,34,41,44 while the longterm outcomes were inconsistent. 22,45,53,56 Sports medicine has been developing fast in China for the last decade. ACL reconstruction now can be routinely performed for the ACL-injured athletic population in most regions of the country.…”

Anterior Cruciate Ligament Reconstruction with LARS Artificial Ligament—Clinical Results after a Long-Term Follow-Up

“…Although the LARS ligament has been used for ACL reconstruction since the late 1990s, there are very few studies that analyzed the long-term results and sometimes the reported data are discordant. 18 19 20 21 Cerulli et al 18 reported the results obtained with the use of LARS ligament in ACL reconstruction in a group of 25 patients after 9 years of follow-up. The authors reported satisfactory results in over 95% of the cases with no cases of knee synovitis.…”

“…They reported a failure rate of 4.4%, and an overall complication rate of 2.2% with 86.6% of the patients returning to their sports activities. Wang et al 20 reported on 26 cases of ACL reconstruction with LARS after a mean follow-up of 11.9 years. The authors reported a complication rate of 28.6% with two cases of knee synovitis.…”

A Long Shot

“…As these authors note, synthetic ACL substitutes have historically had unacceptably high failure rates. The specific device that they used has generated acceptance among some surgeons 2,3,10,18,32 but also several unfavorable reports of frequent failures 12,30,33 and sporadic cases of intense synovitis 10,11,32 or foreign-body reaction. 31 The current authors attribute their success with the synthetic device to the strict requirement for remnant preservation and careful attention to tunnel positioning.…”