Krupa Sebastian, Królikowska Aleksandra, Reichert Paweł
The Center of Rehabilitation and Medical Education, Wrocław, Poland.
The College of Physiotherapy, Wrocław, Poland.
Polim Med. 2016 Jul-Dec;46(2):155-161. doi: 10.17219/pim/68646.
One of the goals of the synthetic materials used in knee joint reconstruction of the anterior cruciate ligament (ACL) is to improve the strength and stability of the graft immediately after the reconstruction. One of the synthetic grafts is a non-absorbable synthetic ligament device made of terephthalic polyethylene polyester fibers, the Ligament Advanced Reinforcement System (LARS).
The aim of the study was to assess postoperative knee joint stability in patients who had undergone ACL reconstruction using the LARS graft.
The study group was comprised of 20 males who had undergone primary unilateral intraarticular ACL reconstruction using LARS. The patients were evaluated one day before the reconstruction and an average of six weeks postoperatively. Knee stability was evaluated manually using the Lachman test, anterior drawer test and pivot-shift test. Knee active range of motion (ROM) was measured.
Preoperatively, the Lachman test indicated abnormal/2+ results in the vast majority of the patients. The postoperative results in most of the patients were normal/0. The anterior drawer test results were also abnormal/2+ preoperatively and normal/0 postoperatively. The pivot-shift test was positive in all of the patients before the ACL reconstruction and negative after the surgery. In general, no differences were found in the ROM between the involved and uninvolved limbs and in the between-measurement comparison.
The evaluation demonstrated significant progress from the preoperative to postoperative results in reducing anterior translation and anterolateral rotational instability of the tibia in patients who had undergone ACL reconstruction using the synthetic LARS graft. In the short-term follow-up assessments, restoration of anterior and anterolateral rotational stability of the operated knee joints was observed.
用于前交叉韧带（ACL）膝关节重建的合成材料的目标之一是在重建后立即提高移植物的强度和稳定性。其中一种合成移植物是由聚对苯二甲酸乙二酯纤维制成的不可吸收合成韧带装置，即韧带增强系统（LARS）。
本研究的目的是评估使用LARS移植物进行ACL重建的患者术后膝关节的稳定性。
研究组由20名接受初次单侧关节内ACL重建并使用LARS的男性组成。在重建前一天和术后平均六周对患者进行评估。使用拉赫曼试验、前抽屉试验和轴移试验手动评估膝关节稳定性。测量膝关节活动范围（ROM）。
术前，绝大多数患者的拉赫曼试验结果为异常/2+。大多数患者术后结果为正常/0。前抽屉试验结果术前也为异常/2+，术后为正常/0。所有患者在ACL重建前轴移试验均为阳性，术后为阴性。总体而言，患侧与未患侧肢体的ROM以及测量之间的比较均未发现差异。
评估表明，对于使用合成LARS移植物进行ACL重建的患者，从术前到术后在减少胫骨前向平移和前外侧旋转不稳定方面取得了显著进展。在短期随访评估中，观察到手术膝关节的前向和前外侧旋转稳定性得到恢复。
