Augmented short undersized hamstring tendon graft with LARS® artificial ligament versus four-strand hamstring tendon in anterior cruciate ligament reconstruction: preliminary results.

BACKGROUND: This retrospective study compares the results of reconstruction of isolated chronic anterior cruciate ligament rupture using augmented short undersized sized hamstring tendon graft with ligament advanced artificial reinforcement system (LARS) versus a four-strand hamstring tendon graft (4-SHG). Our hypothesis was that postoperative knee stability after using augmented short length or small diameter hamstring tendon graft with LARS artificial ligament could be significant and satisfactory more than 4-strand hamstring tendon graft group. MATERIALS AND METHODS: Between June 2007-July 2008, 72 patients were divided into a (LARS) augmented group (n=27) and a (4-SHG) group (n=45). RESULTS: Mean FU is 5years. KT-1000 examinations showed that the LARS group had significantly less anterior displacement than the (4-SHG) group P=0.013. IKDC score demonstrated statistically significant differences (P=0.05). CONCLUSIONS: Our study indicates that early results of augmenting: short length or small diameter harvested hamstring tendons with LARS in ACL reconstruction provides satisfactory, comparable results and displayed higher knee stability compared to (4-SHG) group. LEVEL OF EVIDENCE: Level III (case control study).

The use of the LARS artificial ligament to augment a short or undersized ACL hamstrings tendon graft.

The aim of this study is to evaluate the midterm results of using Ligament Advanced Reinforcement System (LARS) artificial ligament for augmentation of the short (<15 cm length) and small-sized (3-4 mm) diameter for the gracilis and (4-5 mm) for the semitendinosus harvested hamstring tendons in anterior cruciate ligament (ACL) reconstruction, and to assess the knee stability, patient satisfaction and early- and midterm complications following surgery. A total of 112 patients were included in this study and were operated with arthroscopic ACL reconstruction using (augmented hamstring tendon graft with LARS) between January 2004 and December 2006. Assessment before and after the surgery include the history, clinical examination, modified international knee documentation committee score (IKDC), KT1000 measurements for clinical knee stability and osteoarthritis outcome score (KOOS) for patient satisfaction. Clinical results measured by IKDC evaluation, KT1000 and Lysholm scores showed significant postoperative values compared with the preoperative ones. Our findings suggest that at the end of a 5-year follow-up, augmented hamstring tendon graft with LARS artificial ligament is a useful, safe and satisfactory treatment option for ACL reconstruction in deficient knees with short- and small-sized harvested hamstring tendons, especially when an early return to high levels of sport activity is needed.

Tissue levels of histamine, PAF-acether and lysopaf-acether in carrageenan-induced granuloma in rats.

The tissue concentrations of several inflammatory mediators were determined from day 0 to day 60 in granuloma induced in rats (n = 105) by injection of carrageenan in the fascia of the latissimus dorsi muscle. Noncollagen proteins (NCP) and the number of polymorphonuclear leukocytes (PMN) and mast cells were also assessed. In comparison with the tissue at time 0, we noted in the inflamed tissue (at 4 h) an increase in total proteins (4.0 +/- 3.0 vs. 84 +/- 12.0%, mean +/- SEM) and PMN (0.0 +/- 0.0 vs. 43.3 +/- 13.4%), and a fall in histamine concentration (from 30.0 +/- 9.0 to 9.0 +/- 4.0 ng/ml). A partial disappearance of mast cells and an increase of PAF-acether (PAF) levels (1.0 +/- 1.0 vs. 30.0 +/- 22.0 ng/ml) was noted at 16 h, whereas lysopaf remained unchanged (3.7 +/- 4.0 vs. 3.5 +/- 1.0 ng/ml). During evolution towards chronic inflammation (day 10-60), NCP decreased, PMN disappeared and mast cells reappeared; the histamine level rose to 11.0 +/- 2.0 mg/ml, thus not reaching back baseline values. Lysopaf rose to 7.1 +/- 12.2 ng/ml and PAF levels increased further to reach 240.0 +/- 153.0 ng/ml at day 10. This study suggests that PAF may contribute to the acute phase of an inflammatory state such as the carrageenan-induced granuloma and that it is also present during the chronic process.