Clinical outcomes of anterior cruciate ligament reconstruction using LARS artificial graft with an at least 7-year follow-up

Abstract

The aim of our study was to assess the medium-term clinical outcomes of anterior cruciate ligament (ACL) reconstruction using the Ligament Advanced Reinforcement System (LARS) artificial ligament.A total of 168 patients who underwent arthroscopic ACL reconstruction with the LARS artificial ligament in our department were enrolled in our research. Only 125 met the inclusion/exclusion criteria, and 91 could ultimately be contacted to participate in our research. The mean follow-up was 92 ± 19 months. Physical examinations and a KT-1000 arthrometer were used to evaluate knee laxity. The International Knee Documentation Committee (IKDC) and Lysholm knee scales were evaluated for knee function. The Tegner score was tested for the condition of return to sport. Range of motion (ROM) and the rates of failure and complications were calculated.Among all patients enrolled in the study, the failure rate was 4.4%, and the overall complication rate was 2.2%. Knee laxity measured by the KT-1000 arthrometer was 1.4 ± 1.5 mm, compared with the preoperative value of 5.1 ± 1.3 mm. The Lysholm score improved from a preoperative value of 54.6 ± 14.3 to a postoperative value of 85.4 ± 12.1. The proportion of return to sport was 86.8% (79/91). The postoperative Tegner score was 4.7 ± 1.3, while its value before injury was 5.5 ± 1.0.In this study, ACL reconstruction using the LARS artificial ligament has a good prognosis with a low failure and complication rate at a mean follow-up of 91 months.Abbreviations: ACL = anterior cruciate ligament, BPTB = one-patellar tendon-bone, FDA = Food and Drug Administration, IKDC = the International Knee Documentation Committee, LARS = the Ligament Advanced Reinforcement System, PET = polyethylene terephthalate, ROM = range of motion.

Role of Biomaterials and Controlled Architecture on Tendon/Ligament Repair and Regeneration

“…As a result of suboptimal biological properties on these devices, rates of clinical failure or complications reported in various clinical studies for the more recent Leeds–Keio (LK) and LARS constructs range from 15% to 28% for LK and from 2.3% to 0% (mean ± standard deviation (SD) = 20 ± 15.2% across the selected refs …”

“…for LARS. There is no current US Food and Drug Administration approved synthetic T/L for clinical use, though both LK and LARS have been in recent clinical circulation in Europe, Asia, and Australia . Synthetic T/L implant failures often present symptoms such as joint instability, which can be confirmed with either intra‐arthroscopic or noninvasive imaging—though contrast with surrounding tissue is often poor for such methods—and pain which often arises from the chronic inflammatory activity associated with extensive foreign body reactions characterized by the presence of numerous foreign body giant cells and can be confirmed histologically ( Figure ).…”

“…Intra‐arthroscopic images of d) intact and e) ruptured LARS ligaments indicated by black arrows. c–e) Reproduced with permission . Copyright 2017, Wolters Kluwer Health.…”

Deciphering the Association of Cytokines, Chemokines, and Growth Factors in Chondrogenic Differentiation of Human Bone Marrow Mesenchymal Stem Cells Using an ex vivo Osteochondral Culture System

“…Allogenic grafts are also frequently used, but they carry a potential risk of immune rejection, infection, and delayed healing. Synthetic osteochondral grafts have been used for the treatment of osteochondral lesions (Pearce et al, 2012), and they provide a viable alternative option to both autologous and allogenic grafts but are still under evaluation for their large-scale clinical applications (Jia et al, 2017). Another significantly advanced approach for the healing of damaged articular cartilage is autologous chondrocyte implantation (ACI), which involves arthroscopic removal of a small piece of articular cartilage from the patient's knee for self-repair.…”

Hydroxypropylcellulose Coating to Improve Graft-to-Bone Healing for Anterior Cruciate Ligament Reconstruction

“…Currently, the Ligament Advanced Reinforcement System (LARS) ligament (Surgical Implants and Devices, Arc-sur-Tille, France), which is made from polyethylene terephthalate (PET), is one of the choices for grafting in ACL injury 5 . Several clinical studies have shown that the LARS ligament possesses several potential postoperative benefits, including the early return to unrestricted sports and strenuous activities, and avoidance of complications caused by using the autografts or allografts, which indicates that it is a good choice for use in ACL reconstruction [6][7][8][9] . However, some failure cases have been reported when this artificial ligament is used for reconstructing ACL [10][11][12][13] .…”