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Objective: To explore the effectiveness of patellar tendon reconstruction by using LARS artificial ligament in treatment of old patellar tendon rupture. Methods: A clinical data of 12 patients with old patellar ligament ruptures, who met the inclusive criteria and reconstructed with LARS artificial ligament between December 2011 and December 2017, was retrospectively analyzed. There were 8 males and 4 females with an average age of 33.5 years (range, 18-55 years). The cause of injury included traffic accident injury in 4 cases, sport injury in 5 cases, and violent injury in 3 cases. There were 5 cases in the left knee and 7 cases in the right knee. The disease duration was 2-12 weeks (mean, 2.5 weeks). The preoperative Lysholm score and Kujala score were 43.2±3.2 and 43.9±2.6, respectively. The knee range of motion was (106.5±14.7)°. The thigh circumference which was measured at 10 cm above the upper end of the patella was (40.92±1.93) cm. There were 4 cases of patellar ligament body rupture, 1 case of patella distal pola rupture, and 7 cases of tibial tuberosity attachment rupture. Preoperative Caton-Deschamps index was 1.47±0.13. Results: All patients were followed up 12-30 months (mean, 20.5 months). All incisions healed by first intention. And no complication such as infection, recurrent rupture, and neurovascular injury occurred. At 1 year after operation, the knee range of motion was (131.0±10.2)°, Lysholm score was 87.4±2.4, Kujala score was 88.3±4.8, the thigh circumference which was measured at 10 cm above the upper end of the patella was (42.58±1.93) cm; all showing significant differences when compared with preoperative values ( P<0.05). The effectiveness results were excellent in 9 cases and good in 3 cases according to the Insall evaluation criteria. The Caton-Deschamps index was 1.09±0.11, which was significantly lower than preoperative one ( t=8.155, P=0.000). Conclusion: Patellar tendon reconstruction with LARS artificial ligament is an effective method for the old patellar ligament rupture, which can effectively repair the knee extension device and restore knee function.
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Objective To investigate the effect of the use of autologous hamstring tendon plus peroneal longus tendon and the application of LARS artificial ligament reconstruction of posterior cruciate ligament (PCL) knee function and recovery of mechanical stability. Methods Forty-three patients with posterior cruciate ligament rupture were divided into two groups according to the type of graft used during the operation : the LARS artificial ligament group (22 cases) and the autologous hamstring tendon plus peroneal longus tendon group (21 cases). The postoperative follow-up time was at least two years. The knee joint function was evaluated using the knee joint Lysholm score, IKDC score, and Tegner score. The post-drawer test evaluated mechanical stability. Results After 43 cases were followed up completely, the knee joint stability and function indexes of the two groups were significantly improved compared with preoperative ones. The differences were statistically significant (P < 0.05).At the same time, for all postoperative scores, two There was no significant difference between groups (P> 0.05).Conclusion The application of autologous hamstring tendons plus peroneal longus tendon anterior bundle and LARS artificial ligament reconstruction posterior cruciate ligament can achieve satisfactory clinical curative effect.
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Objective Clinically, the anterior cruciate ligament ( ACL) can be reconstructed by either ligament advanced reinforcement system ( LARS) artificial ligament or hamstring tendon autograft ( HTAG) . This study aims to compare the early clinical outcomes of LARS versus HTAG in the treatment of ACL. Methods This study included 38 cases of ACL injury treated in our de-partment from March 2012 to August 2014, 18 by LARS artificial ligament and the other 20 by HTAG. Before and at 18 months after surgery, we evaluated the clinical outcomes of the tow strategies using the Lysholm knee scoring scale and International Knee Documen-tation Committee ( IKDC) scoring systems, and conducted statistical analysis on the follow-up findings. Results Statistically signifi-cant differences were not observed preoperatively between the LARS and HTAG groups either in the Lyshrolm scores (46.78±1.52 vs 46.80 ±1.89, P>0.05) or in the IKDC scores (42.83±1.47 vs 42.20±1.61, P>0.05), nor at 18 months postoperatively in the Lyshrolm scores (93.52±3.19 vs 94.10±1.37, P>0.05) or the IKDC scores (92.11± 1.45 vs 93.15±1.76, P>0.05). However, both the LARS and HTAG groups showed significant differences in the Lyshrolm and IKDC scores at the baseline as compared with those at 18 months after oper-ation ( P<0.05) . Conclusion Both LARS artificial ligament ham-string tendon autograft can achieve good early clinical outcomes in ACL reconstruction.
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Objective To compare the curative effect of arthroscopic transtibial single-bundle posterior cruciate ligament(PCL) reconstruction using LARS artificial ligament and hamstring tendon autograft.Methods Thirty-seven patients who underwent isolated single-bundle PCL reconstruction with remnant preservation technique were evaluated.They were divided into LARS group(n=19) and 4-strand hamstring tendon autograft (4SHG) group (n =18).Minimum follow-up was 2 years.Patients were evaluated preoperatively and postoperatively at the latest follow-up with several parameters,including the international knee documentation committee(IKDC) score,Lysholm knee score,Tegner activity rating and physical examination.Results After operation,in LARS group,Lysholm sorce was 89 (51,100) points,Tegner sorce was 6 (1,9) points,IKDC sorces were normal of 5 cases,nearly normal of 10 cases,abnormal of 3 cases,and obviously abnormal of 1 case,significantly improved compared with before operation (62 (28,98) points,2 (1,5) points,abnormal IKDC score of 8 cases,obviously abnormal of 11 cases;P＜0.001).In 4SHG group,Lysholm sorce was 84(36,100) points,Tegner sorce was 6(1,9) points,IKDC sorces were normal of 5 cases,nearly normal of 9 cases,abnormal of 3 cases,and obviously abnormal of 1 case,better than before operation (64 (28,98) points,2 (1,5) points,IKDC score abnormal of 8 cases,obviously abnormal of 10 cases;P＜0.001).There was significant difference about Lysholm sorce between two groups after operation (P=0.037).The drawer test results show that,after operation,there were 15 case of grade 0,4 cases of grade 1 in LARS group,3 cases of grade 0,11 cases of grade 1,4 cases of grade 2 in 4SHG group,all improved significantly compared with before operation,and the differences were statistically significant(LARS group:x2 =38.000,P＜0.001;4SHG group:x2 =29.143,P＜0.001),and the grade of patients in LARS group were superior to 4SHG group after operation (x2 =15.251,P ＜0.001).Conclusion The clinical effect of using a LARS ligament for PCL reconstruction is more useful than using a 4SHG.
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Objective To investigate the nursing experience during posterior cruciate ligament(PCL)reconstruction using LRAS artificial ligament under arthroscopy.Method The experience in nursing 51 cases of PCL reconstruction using LARS artificial ligament under arthroscopy from 2009 to 2012 was retrospectively summarized.Results It showed that KDC score of the 39 cases was excellent and 12 cases good,with the excellent and good rate of 100.0%.The average operation duration was(70.0±6.0)min and the average blood lose(50±3.6)ml.Conclusion Sufficient preparation before operation,much familiarity with LARS artificial ligament,skilled and accurate surgical cooperation are important factors for the success of PCL reconstruction using LARS artificial ligament under arthroscopy.
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Objective To evaluate the knee joint function at 3-7 years after anterior cruciate ligament (ACL) reconstruction with ligament advanced reinforcement system (LARS) artificial ligament and assess the morphologic changes of LARS artificial ligament in human tissues.Methods Fifty-seven patients (58 knees) undergone ACL reconstruction with LARS artificial ligament were recruited to this multi-factor retrospective study and divided into acute injury group and chronic injury group according to time between injury and operation.LARS artificial ligament harvested from the three patients (4 knees)who had an additional surgery were observed histologically.Results Knee joint function and range of movement were significantly improved after surgery (P ＜ O.O1),however subjective and objective estimation on knee joint function presented no statistical differences between the two groups (P ＞0.05).X-ray films and MRI revealed different degree of bone tunnel progressive augmentation in average 1.5 years,indistinctive correlation of knee joint stability with bone tunnel augmentation (P ＞ 0.5) as well as no statistical difference concerning incidence of tibial and femoral bone tunnel augmentation (P ＞ 0.05).Histological observation revealed well-arranged fiber tissue growth into LARS artificial ligament as well as fibrous joint among single-beam polyester fibers as well as a bundle of polyester fibers at postoperative 2 years.Conclusions (1) LARS artificial ligament gains a satisfactory knee joint stability and function in ACL reconstruction.(2) There exists bone tunnel augmentation that tends to stability at postoperative 1.5 years,but knee joint stability is not correlated to the extent of bone tunnel augmentation after surgery.(3) Postoperative data evaluation of acute injury and chronic injury is the same.(4) Human normal fibrous tissues grow into LARS artificial ligament regularly.
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Objective To explore the treatment method and clinical effect of LARS artificial ligament in treatment of combined anterior cruciate ligament(ACL) and posterior crueiate ligament (PCL) injuries of the knee under arthroscope. Methods Thirteen cases of ACL and PCL injuries were reconstructed with LARS ligament. The patients were followed up for 12-36 months. The International Knee Documentation Committee (IKDC) and Lysholm knee score scale were used for functional evaluation. In the meantime, KT-1000 was employed to check anterior and posterior laxation of the knee. Results No knee infection or limitation of knee extension occurred. Knee flexion was 105° -125° (average 117°). At termination of follow up, 10 cases (77%) was graded as A and 3 (23%) as B according to IKDC. KT-1000 examination at 25° flexion showed that the difference of anterior laxation was less than 2 mm in 12 cases and 3-5mm in 1. KT-1000 examination at 70°flexion showed that the difference of anterior laxation was less than 2mm in 12 cases and 2-4 mm in 1. The Lysholm score was (63.8±2.9) points (49459 points) before operation and (91.1 ±2.7) points (88-95 points) at follow up, with statistical difference (P ＜0.01). Conclusion Reconstruction of ACL and PCL by using LARS ligament under arthroscope is a kind of minimally invasive, safe and effective method to treat ACL and PCL injuries of the knee, with good short term outcome.