[Short-term effectiveness of anterior cruciate ligament reconstruction with LARs artificial ligament].Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2011; 25(8):921-4ZX
To investigate the surgical technique and short-term effectiveness of anterior cruciate ligament (ACL) reconstruction with LARS artificial ligament.
Between November 2008 and April 2010, eighty patients with ACL injury were treated with LARS artificial ligament under arthroscope and successfully followed up. There were 51 males and 29 females, aged from 17 to 43 years with an average of 29.2 years. The injuries were caused by sport in 63 cases, traffic accident in 14 cases, and bruise in 3 cases. There were 43 left knees and 37 right knees. The disease duration ranged from 10 days to 11 months. The anterior drawer test, Lachman test, and pivot shift test for all cases were rated as positive. The preoperative Lysholm score was 55.4 +/- 5.7, Irgang score was 48.3 +/- 6.2, and Larson score was 54.8 +/- 7.4; and the International Knee Documentation Committee (IKDC) score was lower than normal level in all cases. Oblique coronal MRI showed ACL injury in all cases. Residual ACL and synovium were preserved during surgery.
All incisions healed by first intention without complication of infection or deep venous thrombosis. All patients were followed up 7 to 24 months with an average of 16.8 months. There were 3 cases of screws exposure toward femoral cortical bone, 2 cases of loosening tibial screw, and 1 case of knee extension limitation, and they were cured after symptomatic treatment. No LARS artificial ligament rupture and joint fibrosis occurred during follow-up. At last follow-up, the results of anterior drawer test, Lachman test, and pivot shift test were positive in 2, 3, and 3 patients, respectively. There were significant differences in Lysholm, Irgang, and Larson scores of affected knees between preoperation and 6 weeks postoperatively, last follow-up, respectively (P < 0.05). The normal rate of IKDC score were 43.75% (35/80) and 97.50% (78/80) at 6 weeks postoperatively and last follow-up, respectively.
The viscoelastic properties of LARS artificial ligament is different from that of biological materials. The graft should be fixed at a relatively extension position to avoid knee extension limitation and slight loosening of graft tension is permitted at flexion position. Good clinical result could be achieved if the technique is well applied.