Treatment results and safety assessment of the LARS system for the reconstruction of the anterior cruciate ligament

Adv Clin Exp Med. 2021 Apr;30(4):379-386. doi: 10.17219/acem/132037.

Abstract

Background: Anterior cruciate ligament (ACL) reconstruction is the prevailing procedure in cases of ACL rupture.

Objectives: To assess the long-term safety of implementing a synthetic ligament with the Ligament Advanced Reinforcement System (LARS) in primary reconstruction of the ACL.

Materials and methods: The retrospective analysis involved 403 patients who had undergone ACL reconstruction with the same results in clinical and functional assessments. The patients comprised 2 groups. In group I, a LARS graft was implemented, while in group II, an autograft was used. The Lachman test, anterior drawer test, pivot-shift test, Lysholm scale, IKDC 2000, pain posited to be experienced, the possibility of postoperative complications, the time required to return to work, and revision surgery were all considered and analyzed.

Results: The visual analogue scale (VAS) pain score in group I ranged from 37.34 ±8.22 mm on day 3 to 17.21 ±5.45 mm on day 28. In group II, it ranged from 64.72 ±10.20 mm on day 3 (p < 0.05) to 18.67 ±6.57 mm on day 28. The period of time taken to return to office work in group I was 7.04 ±1.82 weeks, and 9.21 ±1.75 weeks in group II (p < 0.05). The time taken to return to physical work in group I was 20.50 ±2.91 weeks, and 21.12 ±3.12 weeks in group II. Postoperative scar and local complications were statistically less prominent in group I. The cost and number of revision surgeries were greater in the first group.

Conclusions: Reconstruction of the ACL using a synthetic graft such as LARS yields similar results to an autograft in a cohort follow-up. Long-term results show a large number of revision surgeries when LARS is used. This method should be used with caution.

Keywords: ACL reconstruction; LARS graft; arthroscopy; autograft; synthetic graft.

MeSH terms

  • Anterior Cruciate Ligament / surgery
  • Anterior Cruciate Ligament Injuries* / surgery
  • Anterior Cruciate Ligament Reconstruction*
  • Humans
  • Knee Joint
  • Retrospective Studies
  • Treatment Outcome