Surgical treatment of acromioclavicular dislocation with LARS artificial ligament

Abstract

The choice of the most appropriate procedure for surgical treatment of type IV-V and VI dislocations of the acromioclavicular joint according to Rockwood's classification has always been troublesome because of complications such as residual instability of the joint, delayed arthrosis of the A-C, delayed osteolysis of the clavicle, host intolerance towards artificial ligaments and because of the need of early mobilization of the affected limb. In our study, 17 male patients, ranging in age from 21 to 79 years and affected by A-C dislocation grade IV and V, both acute and chronic, underwent surgical reconstruction of the A-C joint capsule and extra-articular ligaments with ligament augmentation and reconstruction system (LARS) artificial ligament. Following surgery, their affected limb was braced for 3 days and thereafter all patients began an early active and passive mobilization programme. Patients eventually all returned to their previous working and recreational activities. Throughout thorough clinical and radiographic evaluation and the use of both Constant score and Simple Shoulder test, the aim of our study is to prove that at mid-term follow-up, the reconstruction of the conoid and trapezoid ligaments with LARS is a valid and safe alternative to other procedures.

Acromioclavicular joint reconstruction with the LARS ligament in professional versus non-professional athletes

“…Postoperative good clinical results achieved by both groups were comparable to those reported by other authors with lArS ligament reconstruction at short-term follow-up [6,10,11]. Postoperative good clinical results achieved by both groups were comparable to those reported by other authors with lArS ligament reconstruction at short-term follow-up [6,10,11].…”

“…lArS ligaments are made by polyethylene terephthalate (PeT). however, there are only few clinical reports about the use of lArS artificial ligaments for AC joint repair and this is the first study reporting outcomes of this procedure in professional athletes [6,[9][10][11]. It also is has been shown to encourage collagen ingrowth [16].…”

Clinical and radiological results after coracoclavicular ligament reconstruction for type III acromioclavicular joint dislocation using three different techniques. A retrospective study

“…Given that the CC ligaments are considered the primary suspensory restraint of the ACJ against superior and posterior translation of the distal clavicle with respect to the scapula (4,5), current techniques focus on anatomical restoration of the CC ligament complex (6,7). The LARS (Ligament Augmentation and Reconstruction System) (Corin, Cirencester, UK) has proven to provide highly resistant, separate reconstruction of the conoid and trapezoid ligaments; this is achieved through the use of biomimetic artificial ligament made of polyester fibers (8)(9)(10).…”

Current practice in the management of Rockwood type III acromioclavicular joint dislocations—National survey

“…[22][23][24][25][26][27][28][29] LockDown and LARS techniques represented the first and second most popular techniques, for both acute and delayed injury groups. Helfen et al also proved that due to inconsistent study designs, there is no evidence for a general superiority of any of the open or arthroscopic procedures.…”