Download PDF
CC BY-NC-ND 4.0 · Joints 2018; 06(02): 075-079
DOI: 10.1055/s-0038-1653950
Original Article
Georg Thieme Verlag KG Stuttgart · New York

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

Paolo Domenico Parchi
1   1st Orthopedic Division of Pisa University, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
,
Gianluca Ciapini
1   1st Orthopedic Division of Pisa University, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
,
Carlo Paglialunga
1   1st Orthopedic Division of Pisa University, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
,
Michele Giuntoli
1   1st Orthopedic Division of Pisa University, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
,
Carmine Picece
1   1st Orthopedic Division of Pisa University, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
,
Fabio Chiellini
1   1st Orthopedic Division of Pisa University, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
,
Michele Lisanti
1   1st Orthopedic Division of Pisa University, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
,
Michelangelo Scaglione
1   1st Orthopedic Division of Pisa University, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
› Author Affiliations
Further Information

Publication History

21 August 2017

08 April 2018

Publication Date:
23 May 2018 (online)

   Permissions and Reprints

Abstract

Purpose The aim of this retrospective study was to evaluate the subjective and functional outcome of anterior cruciate ligament (ACL) reconstruction with the synthetic Ligament Advanced Reinforcement System (LARS) ligament.

Methods Twenty-six patients were reviewed at an average follow-up of 11.6 years. Objective clinical evaluation was performed with stability tests. Patient-reported outcomes (Visual Analogue Scale, Knee Injury and Osteoarthritis Outcome Score, and Cincinnati Knee Rating Scale) were used to assess subjective and functional outcomes.

Results Overall satisfactory results were obtained in 22 cases (84.6%). Four patients (15.4%) showed mechanical failure of the graft. No cases of synovitis or infection were reported.

Conclusion LARS ligament can be considered a safe and suitable option for ACL reconstruction in carefully selected cases, especially elderly patients needing a rapid postoperative recovery.

Level of Evidence Level IV, retrospective case series.

Keywords

anterior cruciate ligament - reconstruction - ligament reinforcement - artificial ligament - LARS ligament
 

  • References

  • 1 Budny J, Fox J, Rauh M, Fineberg M. Emerging trends in anterior cruciate ligament reconstruction. J Knee Surg 2017; 30 (01) 63-69
    Thieme ConnectPubMedSearch in Google Scholar
  • 2 Kim HS, Seon JK, Jo AR. Current trends in anterior cruciate ligament reconstruction. Knee Surg Relat Res 2013; 25 (04) 165-173
    CrossrefPubMedSearch in Google Scholar
  • 3 Samuelsson K, Andersson D, Karlsson J. Treatment of anterior cruciate ligament injuries with special reference to graft type and surgical technique: an assessment of randomized controlled trials. Arthroscopy 2009; 25 (10) 1139-1174
    CrossrefPubMedSearch in Google Scholar
  • 4 Smith SA. The diagnosis and treatment of injuries to the crucial ligaments. Br J Surg 1918; 6 (22) 176-189
    CrossrefPubMedSearch in Google Scholar
  • 5 Bolton CW, Bruchman WC. The GORE-TEX expanded polytetrafluoroethylene prosthetic ligament. An in vitro and in vivo evaluation. Clin Orthop Relat Res 1985; (196) 202-213
    PubMedSearch in Google Scholar
  • 6 Richmond JC, Manseau CJ, Patz R, McConville O. Anterior cruciate reconstruction using a Dacron ligament prosthesis. A long-term study. Am J Sports Med 1992; 20 (01) 24-28
    CrossrefPubMedSearch in Google Scholar
  • 7 Rading J, Peterson L. Clinical experience with the Leeds-Keio artificial ligament in anterior cruciate ligament reconstruction. A prospective two-year follow-up study. Am J Sports Med 1995; 23 (03) 316-319
    CrossrefPubMedSearch in Google Scholar
  • 8 Fujikawa K, Iseki F, Seedhom BB. Arthroscopy after anterior cruciate reconstruction with the Leeds-Keio ligament. J Bone Joint Surg Br 1989; 71 (04) 566-570
    PubMedSearch in Google Scholar
  • 9 Parchi PD, Gianluca C, Dolfi L. , et al. Anterior cruciate ligament reconstruction with LARS™ artificial ligament results at a mean follow-up of eight years. Int Orthop 2013; 37 (08) 1567-1574
    CrossrefPubMedSearch in Google Scholar
  • 10 Schuster AJ, McNicholas MJ, Wachtl SW, McGurty DW, Jakob RP. A new mechanical testing device for measuring anteroposterior knee laxity. Am J Sports Med 2004; 32 (07) 1731-1735
    CrossrefPubMedSearch in Google Scholar
  • 11 Collins NJ, Misra D, Felson DT, Crossley KM, Roos EM. Measures of knee function: International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Knee Injury and Osteoarthritis Outcome Score (KOOS), Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS), Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL), Lysholm Knee Scoring Scale, Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Activity Rating Scale (ARS), and Tegner Activity Score (TAS). Arthritis Care Res (Hoboken) 2011; 63 (Suppl. 11) S208-S228
    CrossrefPubMedSearch in Google Scholar
  • 12 Barber-Westin SD, Noyes FR, McCloskey JW. Rigorous statistical reliability, validity, and responsiveness testing of the Cincinnati knee rating system in 350 subjects with uninjured, injured, or anterior cruciate ligament-reconstructed knees. Am J Sports Med 1999; 27 (04) 402-416
    CrossrefPubMedSearch in Google Scholar
  • 13 Savarese A, Lunghi E, Budassi P, Agosti A. Remarks on the complications following ACL reconstruction using synthetic ligaments. Ital J Orthop Traumatol 1993; 19 (01) 79-86
    PubMedSearch in Google Scholar
  • 14 Trieb K, Blahovec H, Brand G, Sabeti M, Dominkus M, Kotz R. In vivo and in vitro cellular ingrowth into a new generation of artificial ligaments. Eur Surg Res 2004; 36 (03) 148-151
    CrossrefPubMedSearch in Google Scholar
  • 15 Dericks Jr G. Ligament advanced reinforcement system anterior cruciate ligament reconstruction. Oper Tech Sports Med 1995; 3: 187-205
    CrossrefPubMedSearch in Google Scholar
  • 16 Anderson MJ, Browning III WM, Urband CE, Kluczynski MA, Bisson LJ. A systematic summary of systematic reviews on the topic of the anterior cruciate ligament. Orthop J Sports Med 2016; 4 (03) 2325967116634074
    PubMedSearch in Google Scholar
  • 17 Batty LM, Norsworthy CJ, Lash NJ, Wasiak J, Richmond AK, Feller JA. Synthetic devices for reconstructive surgery of the cruciate ligaments: a systematic review. Arthroscopy 2015; 31 (05) 957-968
    CrossrefPubMedSearch in Google Scholar
  • 18 Cerulli G, Antinolfi P, Bruè S. , et al. Esperienza clinica nell'uti- lizzo di biomateriali nel ginocchio. GIOT 2011; 37 (Suppl. 01) 159-166
    PubMedSearch in Google Scholar
  • 19 Jia Z, Xue C, Wang W, Liu T, Huang X, Xu W. Clinical outcomes of anterior cruciate ligament reconstruction using LARS artificial graft with an at least 7-year follow-up. Medicine (Baltimore) 2017; 96 (14) e6568
    CrossrefPubMedSearch in Google Scholar
  • 20 Wang C-L, Hsiao C-K, Ku M-C, Chang C-H. Arthroscopic anterior cruciate ligament reconstruction with LARS artificial ligament: an 8–15-year follow-up. J Mech Med Biol 2013; 13 (02) 1350046
    CrossrefPubMedSearch in Google Scholar
  • 21 Tiefenboeck TM, Thurmaier E, Tiefenboeck MM. , et al. Clinical and functional outcome after anterior cruciate ligament reconstruction using the LARS™ system at a minimum follow-up of 10 years. Knee 2015; 22 (06) 565-568
    CrossrefPubMedSearch in Google Scholar
  • 22 Viateau V, Manassero M, Anagnostou F, Guérard S, Mitton D, Migonney V. Biological and biomechanical evaluation of the ligament advanced reinforcement system (LARS AC) in a sheep model of anterior cruciate ligament replacement: a 3-month and 12-month study. Arthroscopy 2013; 29 (06) 1079-1088
    CrossrefPubMedSearch in Google Scholar
  • 23 Li H, Chen S, Wu Y. , et al. Enhancement of the osseointegration of a polyethylene terephthalate artificial ligament graft in a bone tunnel using 58S bioglass. Int Orthop 2012; 36 (01) 191-197
    CrossrefPubMedSearch in Google Scholar
  • 24 Li H, Ge Y, Wu Y. , et al. Hydroxyapatite coating enhances polyethylene terephthalate artificial ligament graft osseointegration in the bone tunnel. Int Orthop 2011; 35 (10) 1561-1567
    CrossrefPubMedSearch in Google Scholar
  • 25 Cho S, Li H, Chen C, Jiang J, Tao H, Chen S. Cationised gelatin and hyaluronic acid coating enhances polyethylene terephthalate artificial ligament graft osseointegration in porcine bone tunnels. Int Orthop 2013; 37 (03) 507-513
    CrossrefPubMedSearch in Google Scholar
  • 26 Antonini S, Meucci S, Parchi P. , et al. Human mesenchymal stromal cell-enhanced osteogenic differentiation by contact interaction with polyethylene terephthalate nanogratings. Biomed Mater 2016; 11 (04) 045003
    CrossrefPubMedSearch in Google Scholar