Postoperative Knee Joint Stability Following Anterior Cruciate Ligament Reconstruction Using the Ligament Advanced Reinforcement System

Abstract

The anterior cruciate ligament (ACL) of the knee joint plays a complex role in the stabilization of the knee joint, resisting anterior displacement and excessive rotation of the tibia relative to the femur [1]. Reconstruction of the ACL of the knee joint [2] followed by a postoperative physiotherapeutic procedure [3] is the standard ACL injury treatment for individuals wishing to return to high-level sports activities. There are numerous current treatment options for ACL reconstruction, and in choosing the technique, the surgeon's experience and numerous patient-specific factors, as well as cost and efficacy, are taken under consideration [4,5]. Broadly, the available graft options include autografts and allografts, as well as synthetic ligaments. The autograft choices consist of the patellar, hamstring (Fig. 1), and quadriceps tendons, while allografts include the quadriceps, patellar, Achilles, hamstring, anterior and posterior tibialis tendons, and the fascia lata AbstractBackground. One of the goals of the synthetic materials used in knee joint reconstruction of the anterior cruciate ligament (ACL) is to improve the strength and stability of the graft immediately after the reconstruction. One of the synthetic grafts is a non-absorbable synthetic ligament device made of terephthalic polyethylene polyester fibers, the Ligament Advanced Reinforcement System (LARS). Objectives. The aim of the study was to assess postoperative knee joint stability in patients who had undergone ACL reconstruction using the LARS graft. Material and Methods. The study group was comprised of 20 males who had undergone primary unilateral intraarticular ACL reconstruction using LARS. The patients were evaluated one day before the reconstruction and an average of six weeks postoperatively. Knee stability was evaluated manually using the Lachman test, anterior drawer test and pivot-shift test. Knee active range of motion (ROM) was measured. Results. Preoperatively, the Lachman test indicated abnormal/2+ results in the vast majority of the patients. The postoperative results in most of the patients were normal/0. The anterior drawer test results were also abnormal/2+ preoperatively and normal/0 postoperatively. The pivot-shift test was positive in all of the patients before the ACL reconstruction and negative after the surgery. In general, no differences were found in the ROM between the involved and uninvolved limbs and in the between-measurement comparison. Conclusions. The evaluation demonstrated significant progress from the preoperative to postoperative results in reducing anterior translation and anterolateral rotational instability of the tibia in patients who had undergone ACL reconstruction using the synthetic LARS graft. In the short-term follow-up assessments, restoration of anterior and anterolateral rotational stability of the operated knee joints was observed (Polim. Med. 2016, 46, 2, 155-161).

Autografts vs Synthetics for Cruciate Ligament Reconstruction: A Systematic Review and Meta‐Analysis

“…Krupa et al . also indicated a significant progress from preoperative to short‐term postoperative result in reducing anterior translation and anterolateral rotational instability of the tibia relative to the femur in patients who had undergone ACL reconstruction with a synthetic LARS graft.…”

“…Regardless of its type, autograft harvest can result in a degree of morbidity, which may negatively affect recovery after ACL reconstruction. The use of allografts has increased in recent years because they offer less donor‐site morbidity, shorter surgical and anesthesia times, fewer postoperative complications, faster postoperative recovery, lower incidence of postoperative arthrofibrosis, less postoperative pain, and an unlimited graft source in the setting of multi‐ligament and revision reconstructions. However, allografts are associated with a higher expense, a risk of disease transmission, delayed healing, ligamentization, and an increased risk of graft rupture in the younger, more active population.…”

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

“…The short-term postoperative results of patients after ACL reconstruction with the use of LARS are very satisfying. 48 A mean 2.5-year follow up carried out by Dericks in 1995 revealed encouraging results of treatment with the use of LARS. 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.…”

Anterior Cruciate Ligament (ACL) Injuries: Modern Strategy of Surgical Treatment (Review)

“…Нативна ПСЗ 2160±157 242±28 [45] BPBT 10 мм 2238±316 455±67 [47] QTB 10 мм 2353±495 621±122 [48] 4-пучковий сухожилок тонкого та напівсухожилкового м'яза 4090±295 276±204 [46] 2-пучковий сухожилок тонкого м'яза 1550±369 370±108 [46] 2-пучковий сухожилок напівсухожилкового м'яза 2640±320 534±76 [46] новлення у післяопераційний період, необмеженість у кількості та виборі типу і розміру трансплантату [63,64] Summary. Of all knee injuries, the most common one is the anterior cruciate ligament (ACL) injury.…”