LARS Artificial Ligament Versus ABC Purely Polyester Ligament for Anterior Cruciate Ligament Reconstruction

Abstract

Background:Graft choice for anterior cruciate ligament (ACL) reconstruction is of critical importance. Various grafts have been used so far, with autografts long considered the optimal solution for the treatment of ACL-deficient knees. Limited data are available on the long-term survivorship of synthetic grafts.Purpose:To compare the functional outcome and survivorship of ACL reconstructions performed using the LARS (ligament augmentation and reconstruction system) ligament and the ABC (active biosynthetic composite) purely polyester ligament.Study Design:Case series; Level of evidence, 4.Methods:The results of 72 patients who underwent primary arthroscopic ACL reconstruction with the LARS ligament and 31 cases with an ABC purely polyester ligament were reviewed. The mean follow-up periods for the LARS and ABC groups were 9.5 and 5.1 years, respectively. A survivorship analysis of the 2 synthetic grafts was performed using the Kaplan-Meier method with a log-rank test (Mantel-Cox, 95% CI). Lysholm, Tegner activity, Knee injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) scores as well as laxity measurements obtained using a KT-1000 arthrometer were recorded for all intact grafts, and a Mann-Whitney U test was used for comparison reasons.Results:The rupture rates for LARS and ABC grafts were 31% (95% CI, 20%-42%) and 42% (95% CI, 25%-59%), respectively. For intact grafts, the mean Lysholm score was good for both groups (90 for the LARS group and 89 for the ABC group), with the majority of patients returning to their preinjury level of activities, and the mean IKDC score was 90 for the LARS group and 86 for the ABC group.Conclusion:The rupture rates of both LARS and ABC grafts were both high. However, the LARS ligament provided significantly better survivorship compared with the ABC ligament at short- to midterm follow-up (95% CI).

Comparison of the effect of the graft with double strands peroneus longus tendon and with the four strands hamstring tendon on reconstruction of the posterior cruciate ligament injury

“…LARS artificial ligament has enough strength to resist repeated distortion and excessive traction, and has the advantages of autologous tissue growth. However, because of its high price, it has not been widely used in clinical treatment [21]. The materials for reconstruction of PCL by autogenous tendon transplantation include bone-patellar tendon and hamstring tendon.…”

A Canine Arthroscopic Anterior Cruciate Ligament Reconstruction Model for Study of Synthetic Augmentation of Tendon Allografts

“…11,14,23 It also allows for functional remodeling ("ligamentization") of the graft, and secure graft-to-bone-socket healing which ensures long-term performance and avoids the untoward responses and failures noted for all-synthetic grafts. [27][28][29] Importantly, the unique configuration of the QTIB construct in conjunction with suspensory fixation ensures that the allograft tendon and suture tape are simultaneously loaded in a self-tensioning mechanism that is designed to ensure load sharing and prevent overprotection of the graft. The success of this design is evident in the clinical, biomechanical, and histologic results, which showed functional graft performance, integration, and remodeling.…”

Elección de injerto en reconstrucción de ligamento cruzado anterior. ¿Existe un injerto ideal?

“…Las prótesis son sustitutos del injerto biológico, fabricados con poliéster y GORE-TEX®; en esta categoría encontramos implantes como el ABC (active biosynthetic composite, Surgicraft Ltd.). Desafortunadamente, estos dispositivos presentan una alta tasa de fracasos y complicaciones (22) . Las matrices de fibras de carbono se asocian a sinovitis, fracaso del crecimiento tisular e integración con los túneles óseos, con la subsecuente pérdida de las propiedades biomecánicas.…”