Ligament Advanced Reinforcement System (LARS) synthetic graft for PCL reconstruction: systematic review and meta-analysis

Migliorini, Filippo; Pintore, Andrea; Vecchio, Gianluca; Oliva, Francesco; Hildebrand, Frank; Maffulli, Nicola

doi:10.1093/bmb/ldac011

Cited by 9 publications

(6 citation statements)

References 55 publications

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“…Indeed, PCL tears can be managed conservatively when up to 10 mm of posterior knee translation is present [ 1 ]. However, surgical PCL reconstruction may be necessary in patients with greater laxity associated with instability [ 38 , 54 ]. Both autografts and allografts have been employed for PCL reconstruction [ 4 , 46 , 53 ].…”

Section: Introductionmentioning

confidence: 99%

Allografts as alternative to autografts in primary posterior cruciate ligament reconstruction: a systematic review and meta-analysis

Migliorini

Pintore

Oliva

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Following posterior cruciate ligament (PCL) rupture, autografts and allografts are routinely used for its reconstruction. This study investigated the efficacy and safety of allografts for primary PCL reconstruction, comparing them to autografts in terms of patient-reported outcome measures (PROMs), functional tests, and complications. Methods This study followed the PRISMA guidelines. PubMed, Web of Science, Google Scholar, Embase, and Scopus were accessed in October 2022. All the clinical studies investigating the outcomes of primary PCL reconstruction using allografts, or comparing the outcomes of allografts versus autografts, were accessed. The outcomes of interests were: instrumental laxity, range of motion (ROM), Telos stress radiography, drawer test, International Knee Documentation Committee (IKDC), Tegner Activity Scale, and the Lysholm Knee Scoring Scale. Data on complications were also recorded. Results A total of 445 patients were included. The mean follow-up was 45.2 ± 23.8 months. The mean age of the patients was 30.6 ± 2.2 years. The time span between the injury and surgical intervention was 12.9 ± 10 months. Overall, 28% (125 of 445 patients) were women. Good baseline comparability was found between the two cohorts. No difference was found in terms of Lysholm Score, ROM, Tegner Scale, IKDC, arthrometer laxity, drawer test, and Telos stress radiography. No difference was found in the rates of anterior knee pain and revision. Conclusion Allografts can be considered a suitable alternative to autografts for PCL reconstruction. Level of evidence III.

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Section: Introductionmentioning

confidence: 99%

Allografts as alternative to autografts in primary posterior cruciate ligament reconstruction: a systematic review and meta-analysis

Migliorini

Pintore

Oliva

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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“…In cruciate ligament reconstruction, the main grafts used are autografts, allografts and synthetic grafts [9]. Autografts, which are typically obtained from tendons such as the quadriceps tendon or the bone-patellar tendon-bone (BPTB), are the most commonly used grafts.…”

Section: Discussionmentioning

confidence: 99%

“…LARS is a controversial alternative to autografts and allografts as it provides a more robust structure that immediately stabilizes the knee and allows patients to participate in high-intensity rehabilitation sooner; however, there is potential for complications such as rupture, inadequate tendon-bone healing, and loosening [12][13][14]. Therefore, in order to benefit from quick recovery and reduce the potential occurrence of arthrofibrosis, LARS was chosen as graft substitute in this setting [9].…”

Section: Discussionmentioning

confidence: 99%

Unicompartmental knee arthroplasty combined with posterior cruciate ligament reconstruction: a case report

Zheng,

Du,

Chu

et al. 2024

BMC Musculoskelet Disord

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Background In this study, we present the unique case of a patient with knee osteoarthritis (OA) of the medial compartment and posterior cruciate ligament (PCL) deficiency who underwent simultaneous medial unicompartmental knee arthroplasty (UKA) and PCL reconstruction. Case presentation A 49-year-old male patient presented with a 1-year history of pain and instability in the left knee. The patient had previously experienced a trauma-related injury to the PCL of the left knee that was left untreated. Imaging and physical examination confirmed the presence of left medial knee OA along with PCL rupture. To address these issues, the patient underwent UKA combined with PCL reconstruction. The patient’s Lysholm score was 47 before surgery and 81 three months after surgery, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was 29 before surgery and 18 three months after surgery, and the International Knee Documentation Committee (IKDC) subjective score was 56.3 before surgery and 74.7 three months after surgery. Six months after surgery, the patient's gait returned to normal, and he was able to jog. Conclusion This case report presents the first instance of UKA combined with PCL reconstruction and introduces a novel treatment approach for patients suffering from medial knee OA and ligament injury.

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“…The tibial tunnel technique approaches the PCL tibial insertion using a specific guide under arthroscopic control and, in some circumstances, fluoroscopic control. The PCL tibial inlay technique allows direct approach to the tibial insertion of the PCL [8][9][10]. Both methods seem to produce equivalent results [1,2,11].…”

Section: Introductionmentioning

confidence: 99%

“…Fig 9. The PCL graft is shuttled into the knee joint through the tunnels using an Ethibond 5.0: A-E showing intraoperative views of the free end of PCL graft (yellow arrow), bone block with 3.5-mm cortical screw and washer of PCL graft (blue cyan arrow) and four stand of hamstring tendon of ACL graft (white arrow)…”

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confidence: 99%

Posterior cruciate ligament reconstruction using PCL inlay technique with the patient supine in bicruciate ligament injury reconstruction

et al. 2023

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Background Surgical reconstruction of the posterior cruciate ligament (PCL) can be technically challenging given the proximity of the popliteal artery to the PCL tibial insertion. This "no-safe zone" makes some knee surgeons less confident and willing to perform this surgical procedure. Surgical technique We present a PCL tibial inlay reconstruction technique using a set of instruments involving three tools (a slot cut, a bone plug positioner, and an impactor). Conclusion This set of instruments allows a more reproducible posteromedial approach and to produce a PCL tibial slot in a posterior cruciate ligament inlay reconstruction with the patient supine in bicruciate ligament injury reconstruction.

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Ligament Advanced Reinforcement System (LARS) synthetic graft for PCL reconstruction: systematic review and meta-analysis

Cited by 9 publications

References 55 publications

Allografts as alternative to autografts in primary posterior cruciate ligament reconstruction: a systematic review and meta-analysis

Allografts as alternative to autografts in primary posterior cruciate ligament reconstruction: a systematic review and meta-analysis

Unicompartmental knee arthroplasty combined with posterior cruciate ligament reconstruction: a case report

Posterior cruciate ligament reconstruction using PCL inlay technique with the patient supine in bicruciate ligament injury reconstruction

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