Outcomes of Arthroscopic Double-bundle PCL Reconstruction Using the LARS Artificial Ligament

Abstract

The purpose of this study was to assess the outcomes of posterior cruciate ligament (PCL) reconstruction using the Ligament Augmentation and Reconstruction System (LARS) (JK Orthomedic Ltd, Dollard-des-Ormeaux, Quebec, Canada) artificial ligament. Compared with older artificial ligaments, the LARS, which has been used in Europe for 15 years, is more resistant to wear and tear, has satisfactory torsional fatigue resistance, and has good biocompatibility. The current is study included 38 double-bundle PCL reconstructions using the LARS artificial ligament in 38 patients. Mean patient age was 32.6 years, and mean time from injury to surgery was 6 months. Mean follow-up was 37 months (range, 30-68 months). The study endpoint was 2-year follow-up. Mean Tegner score improved from 3.4 ± 0.6 preoperatively to 6.0 ± 1.4 postoperatively (P<.001), and mean Lysholm score improved from 70.0 ± 11.0 pre-operatively to 91.7 ± 5.5 postoperatively (P<.001). Knee laxity decreased significantly postoperatively (P<.001), and no differences existed at 1- and 2-year follow-up. After surgery using the Y-type LARS artificial ligament, knee function and stability improved. Using the LARS artificial ligament for double-bundle reconstruction of the PCL avoids donor-site morbidity and disease transmission. The complication rate is low, and the results appear to be stable with time and comparable with those obtained with other grafts. Double-bundle PCL reconstruction with the LARS artificial ligament may be an alternative treatment option.

Kinematic Analysis of the Posterior Cruciate Ligament, Part 2

“…11,17,34 Clinical studies have reported promising outcomes for DB PCLRs, and it has been suggested that native kinematics are more closely reestablished with this technique. 6,32 In addition, kinematic investigations have reported that DB reconstructions result in decreased posterior laxity compared with SB PCLRs across a large range of motion in the knee. 29 However, because of the disparity of the current literature, neither technique has conclusively been determined to be superior.…”

Use of a Fluoroscopic Overlay to Guide Femoral Tunnel Placement During Posterior Cruciate Ligament Reconstruction

“…5 Clinically, the same controversy exists, with some authors showing good outcomes for the single-bundle approach, 7,22,24,38 while others demonstrate good results for double-bundle reconstruction. 9,41 The current study showed that surgeons could be guided toward a target point provided by an overlay system. Moreover, the overlay system helped surgeons to place the femoral tunnels closer to the anatomic insertion site for double-bundle reconstruction.…”

Arthroscopic Reconstruction of the Posterior Cruciate Ligament With Ligament Advanced Reinforcement System and Hamstring Tendon Autograft :A Retrospective Study

“…In a follow-up study lasting for 9.27 years on average, their last follow-up revealed a mean IKDC score of up to 79.32. Chen et al (5) used double-strand LARS for PCL reconstruction, and after two years operatively the average Tegner activity scores were improved to 6.0 from pre-operative 3.4 and the average Lysholm scores were raised to 91.76 from pre-operative 70.06.…”

“…LARS was rst used for ACL reconstruction and achieved excellent results. Since then, some researchers tried to use LARS to reconstruct PCL (5,6). However, few studies had compared the e cacy of LARS and hamstring tendon for the PCL reconstruction.…”