LARS Versus Hamstring Tendon Autograft in Anterior Cruciate Ligament Reconstruction: a Single-centre, Single Surgeon Retrospective Study with 8 years of Follow-up

Overview

Journal Eur J Orthop Surg Traumatol

Specialty Orthopedics

Date 2018 Sep 21

PMID 30232566

Citations 10

Authors

Nicola Bianchi

Federico Sacchetti

Vanna Bottai

Marco Gesi

Alessio Carlisi

Andrea Facchini

Rodolfo Capanna

Stefano Giannotti

Affiliations

Soon will be listed here.

Abstract

Purpose: The choice of graft type in the anterior cruciate ligament (ACL) reconstruction remains a subject of controversy. The aim of this study was to assess the outcomes in ACL reconstructions performed using a four-strand hamstring tendon graft (4SHG) or a LARS ligament comparing the effectiveness of the two grafts at a medium follow-up of 8 years.

Methods: This retrospective, single-centre, single surgeon study evaluated the clinical, functional and radiographic outcomes in 50 patients who underwent ACL reconstruction (25 4SHG and 25 LARS). Patients who underwent surgery after more than 6 months from injury and showed radiographically visible degenerative changes at time of surgery were excluded from the study.

Results: None of the patients underwent re-surgery in the same knee. The range of motion of the operated knee, compared to the contralateral, was good for both groups. The anterior drawer test resulted negative in 21 patients (84%) in the LARS group and eight patients (32%) in the 4SHG group (P = 0.039). The Lachman test was negative in 19 patients (76%) in the LARS group and in 11 patients (44%) in the 4SHG group (P = 0.045). Although other results of ACL reconstruction measured by Lysholm scores, IKDC evaluation, Tegner scores and radiographic images showed using a LARS graft tended to be superior to using a 4SHG, there were no statistically significant differences calculated.

Conclusion: Our results suggest that 4 years after ACL reconstruction using a LARS ligament or 4SHG dramatically improves the function outcome, while the patients in the LARS group displayed a higher knee stability than those in the 4SHG group.

Citing Articles

New Graft Choices for ACL Reconstruction: Update Article.

Lara P, Novaretti J, Nunes G, Cohen M, Ramos L Rev Bras Ortop (Sao Paulo). 2024; 59(5):e642-e649.

PMID: 39649040 PMC: 11624934. DOI: 10.1055/s-0044-1779335.

Four-year comparative analysis of return to sport and psychological recovery following ACL revision: Artificial ligament vs. anterior tibial tendon allograft.

Chen T, Dong Y, Li Y, Chen S J Orthop Translat. 2024; 47:29-38.

PMID: 38994236 PMC: 11237355. DOI: 10.1016/j.jot.2024.05.003.

Anterior Cruciate Ligament Reconstruction with Quadrupled Semitendinosus Graft or Synthetic Ligament: Knee Stability and Clinical Outcomes at Three Years Follow-Up.

Moretti L, Cassano G, Caricato A, Caiaffa E, DAprile M, Angiulli F Adv Orthop. 2023; 2023:4022441.

PMID: 37520887 PMC: 10374376. DOI: 10.1155/2023/4022441.

Outcome of cranial cruciate ligament replacement with an enhanced polyethylene terephthalate implant in the dog: A pilot clinical trial.

Johnson T, Conzemius M Vet Surg. 2022; 51(8):1215-1222.

PMID: 36165283 PMC: 9827950. DOI: 10.1111/vsu.13889.

[Core techniques and adverse events in anterior cruciate ligament reconstruction using a new generation of artificial ligaments: the consensus of Chinese specialists based on a modified Delphi method (Part 2)].

Chinese Specialist Consensus Group On New Generation Artificial Ligaments Used For Anterior Cruciate Ligament Reconstruction Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022; 36(9):1047-1055.

PMID: 36111464 PMC: 9626301. DOI: 10.7507/1002-1892.202206026.

References

Carter T, Edinger S . Isokinetic evaluation of anterior cruciate ligament reconstruction: hamstring versus patellar tendon. Arthroscopy. 1999; 15(2):169-72. DOI: 10.1053/ar.1999.v15.0150161. View

Zarzycki W, Mazurkiewicz S, Wisniewski P . [Research on strength of the grafts that are used in anterior cruciate ligament reconstruction]. Chir Narzadow Ruchu Ortop Pol. 1999; 64(3):293-302. View

Lavoie , Fletcher , DUVAL . Patient satisfaction needs as related to knee stability and objective findings after ACL reconstruction using the LARS artificial ligament. Knee. 2000; 7(3):157-163. DOI: 10.1016/s0968-0160(00)00039-9. View

Beard D, Anderson J, Davies S, Price A, Dodd C . Hamstrings vs. patella tendon for anterior cruciate ligament reconstruction: a randomised controlled trial. Knee. 2001; 8(1):45-50. DOI: 10.1016/s0968-0160(01)00062-x. View

Eriksson K, Anderberg P, Hamberg P, Lofgren A, Bredenberg M, Westman I . A comparison of quadruple semitendinosus and patellar tendon grafts in reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br. 2001; 83(3):348-54. DOI: 10.1302/0301-620x.83b3.11685. View

Feller J, Webster K, Gavin B . Early post-operative morbidity following anterior cruciate ligament reconstruction: patellar tendon versus hamstring graft. Knee Surg Sports Traumatol Arthrosc. 2001; 9(5):260-6. DOI: 10.1007/s001670100216. View

Keays S, Bullock-Saxton J, Keays A, Newcombe P . Muscle strength and function before and after anterior cruciate ligament reconstruction using semitendonosus and gracilis. Knee. 2001; 8(3):229-34. DOI: 10.1016/s0968-0160(01)00099-0. View

Aune A, Holm I, Risberg M, Jensen H, Steen H . Four-strand hamstring tendon autograft compared with patellar tendon-bone autograft for anterior cruciate ligament reconstruction. A randomized study with two-year follow-up. Am J Sports Med. 2001; 29(6):722-8. DOI: 10.1177/03635465010290060901. View

Shaieb M, Kan D, Chang S, Marumoto J, Richardson A . A prospective randomized comparison of patellar tendon versus semitendinosus and gracilis tendon autografts for anterior cruciate ligament reconstruction. Am J Sports Med. 2002; 30(2):214-20. DOI: 10.1177/03635465020300021201. View

10.

Nau T, Lavoie P, Duval N . A new generation of artificial ligaments in reconstruction of the anterior cruciate ligament. Two-year follow-up of a randomised trial. J Bone Joint Surg Br. 2002; 84(3):356-60. DOI: 10.1302/0301-620x.84b3.12400. View

11.

Pinczewski L, Deehan D, Salmon L, Russell V, Clingeleffer A . A five-year comparison of patellar tendon versus four-strand hamstring tendon autograft for arthroscopic reconstruction of the anterior cruciate ligament. Am J Sports Med. 2002; 30(4):523-36. DOI: 10.1177/03635465020300041201. View

12.

Weiler A, Scheffler S, Hoher J . [Transplant selection for primary replacement of the anterior cruciate ligament]. Orthopade. 2002; 31(8):731-40. DOI: 10.1007/s00132-002-0331-z. View

13.

Jansson K, Linko E, Sandelin J, Harilainen A . A prospective randomized study of patellar versus hamstring tendon autografts for anterior cruciate ligament reconstruction. Am J Sports Med. 2003; 31(1):12-8. DOI: 10.1177/03635465030310010501. View

14.

Ejerhed L, Kartus J, Sernert N, Kohler K, Karlsson J . Patellar tendon or semitendinosus tendon autografts for anterior cruciate ligament reconstruction? A prospective randomized study with a two-year follow-up. Am J Sports Med. 2003; 31(1):19-25. DOI: 10.1177/03635465030310011401. View

15.

Talbot M, Berry G, Fernandes J, Ranger P . Knee dislocations: experience at the Hôpital du Sacré-Coeur de Montréal. Can J Surg. 2004; 47(1):20-4. PMC: 3211817. View

16.

Trieb K, Blahovec H, Brand G, Sabeti M, Dominkus M, Kotz R . In vivo and in vitro cellular ingrowth into a new generation of artificial ligaments. Eur Surg Res. 2004; 36(3):148-51. DOI: 10.1159/000077256. View

17.

Harilainen A, Sandelin J, Jansson K . Cross-pin femoral fixation versus metal interference screw fixation in anterior cruciate ligament reconstruction with hamstring tendons: results of a controlled prospective randomized study with 2-year follow-up. Arthroscopy. 2005; 21(1):25-33. DOI: 10.1016/j.arthro.2004.09.013. View

18.

Brunet P, Charrois O, Degeorges R, Boisrenoult P, Beaufils P . [Reconstruction of acute posterior cruciate ligament tears using a synthetic ligament]. Rev Chir Orthop Reparatrice Appar Mot. 2005; 91(1):34-43. DOI: 10.1016/s0035-1040(05)84273-4. View

19.

Marumo K, Saito M, Yamagishi T, Fujii K . The "ligamentization" process in human anterior cruciate ligament reconstruction with autogenous patellar and hamstring tendons: a biochemical study. Am J Sports Med. 2005; 33(8):1166-73. DOI: 10.1177/0363546504271973. View

20.

Mascarenhas R, MacDonald P . Anterior cruciate ligament reconstruction: a look at prosthetics--past, present and possible future. Mcgill J Med. 2008; 11(1):29-37. PMC: 2322926. View