Orthopedics and Traumatology Department, eMKa MED Medical Centre, Wrocław, Poland.
Division of Sports Medicine, Department of Physiotherapy, Faculty of Health Sciences, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2021 Apr;30(4):379-386. doi: 10.17219/acem/132037.
Anterior cruciate ligament (ACL) reconstruction is the prevailing procedure in cases of ACL rupture.
To assess the long-term safety of implementing a synthetic ligament with the Ligament Advanced Reinforcement System (LARS) in primary reconstruction of the ACL.
The retrospective analysis involved 403 patients who had undergone ACL reconstruction with the same results in clinical and functional assessments. The patients comprised 2 groups. In group I, a LARS graft was implemented, while in group II, an autograft was used. The Lachman test, anterior drawer test, pivot-shift test, Lysholm scale, IKDC 2000, pain posited to be experienced, the possibility of postoperative complications, the time required to return to work, and revision surgery were all considered and analyzed.
The visual analogue scale (VAS) pain score in group I ranged from 37.34 ±8.22 mm on day 3 to 17.21 ±5.45 mm on day 28. In group II, it ranged from 64.72 ±10.20 mm on day 3 (p < 0.05) to 18.67 ±6.57 mm on day 28. The period of time taken to return to office work in group I was 7.04 ±1.82 weeks, and 9.21 ±1.75 weeks in group II (p < 0.05). The time taken to return to physical work in group I was 20.50 ±2.91 weeks, and 21.12 ±3.12 weeks in group II. Postoperative scar and local complications were statistically less prominent in group I. The cost and number of revision surgeries were greater in the first group.
Reconstruction of the ACL using a synthetic graft such as LARS yields similar results to an autograft in a cohort follow-up. Long-term results show a large number of revision surgeries when LARS is used. This method should be used with caution.
前交叉韧带(ACL)重建是 ACL 断裂的主要治疗方法。
评估在 ACL 初次重建中使用韧带高级重建系统(LARS)合成韧带的长期安全性。
回顾性分析了 403 例 ACL 重建患者,这些患者在临床和功能评估中结果相同。这些患者分为两组。在组 I 中,使用了 LARS 移植物,而在组 II 中,使用了自体移植物。对 Lachman 试验、前抽屉试验、枢轴移位试验、Lysholm 评分、IKDC 2000、术后疼痛、术后并发症的可能性、重返工作的时间以及翻修手术进行了考虑和分析。
组 I 的视觉模拟评分(VAS)疼痛评分从第 3 天的 37.34±8.22mm 降至第 28 天的 17.21±5.45mm。在组 II 中,从第 3 天的 64.72±10.20mm(p<0.05)降至第 28 天的 18.67±6.57mm。组 I 重返办公室工作的时间为 7.04±1.82 周,组 II 为 9.21±1.75 周(p<0.05)。组 I 重返体力劳动的时间为 20.50±2.91 周,组 II 为 21.12±3.12 周。组 I 的术后瘢痕和局部并发症明显较少。第一组的费用和翻修手术数量更多。
在 ACL 重建中使用合成移植物(如 LARS)与自体移植物在队列随访中获得相似的结果。长期结果显示,使用 LARS 时需要进行大量的翻修手术。这种方法应谨慎使用。