Four-strand hamstring tendon autograft versus LARS artificial ligament for anterior cruciate ligament reconstruction

This retrospective study compared the results after anterior cruciate ligament (ACL) reconstruction using a four-strand hamstring tendon graft (4SHG) versus Ligament Advanced Reinforcement System (LARS) artificial ligament in 60 patients between January 2003 and July 2004 with a minimum four-year follow-up. The KT-1000 examination, the International Knee Documentation Committee (IKDC) scoring systems and Lysholm knee scoring scale were used to evaluate the clinical results. The mean side-to-side difference was 2.4 ± 0.5 mm and 1.2 ± 0.3 mm in the 4SHG group and LARS group, respectively (P = 0.013). Although other results of ACL reconstruction, measured by IKDC evaluation, Lysholm scores and Tegner scores, showed using a LARS graft clinically tended to be superior to using a 4SHG, there were no significant differences calculated. Our results suggest that four 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.

[1]  M. Saito,et al.  The “Ligamentization” Process in Human Anterior Cruciate Ligament Reconstruction with Autogenous Patellar and Hamstring Tendons , 2005, The American journal of sports medicine.

[2]  Jinzhong Zhao,et al.  Double-bundle anterior cruciate ligament reconstruction: four versus eight strands of hamstring tendon graft. , 2007, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[3]  T. Carter,et al.  Isokinetic evaluation of anterior cruciate ligament reconstruction: hamstring versus patellar tendon. , 1999, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[4]  A. Weiler,et al.  Transplantatauswahl für den primären Ersatz des vorderen Kreuzbandes , 2014, Der Orthopäde.

[5]  A. Weiler,et al.  The extracellular remodeling of free-soft-tissue autografts and allografts for reconstruction of the anterior cruciate ligament: a comparison study in a sheep model , 2008, Knee Surgery, Sports Traumatology, Arthroscopy.

[6]  N. Duval,et al.  A new generation of artificial ligaments in reconstruction of the anterior cruciate ligament. Two-year follow-up of a randomised trial. , 2002, The Journal of bone and joint surgery. British volume.

[7]  Arsi Harilainen,et al.  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. , 2005, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[8]  D. Beard,et al.  Hamstrings vs. patella tendon for anterior cruciate ligament reconstruction: a randomised controlled trial. , 2001, The Knee.

[9]  Dragan Savic,et al.  Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. , 2005, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[10]  A L Otero,et al.  A comparison of the doubled semitendinosus/gracilis and central third of the patellar tendon autografts in arthroscopic anterior cruciate ligament reconstruction. , 1993, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[11]  A. K. Aune,et al.  Four-Strand Hamstring Tendon Autograft Compared with Patellar Tendon-Bone Autograft for Anterior Cruciate Ligament Reconstruction , 2001, The American journal of sports medicine.

[12]  P. Wiśniewski,et al.  [Research on strength of the grafts that are used in anterior cruciate ligament reconstruction]. , 1999, Chirurgia narzadow ruchu i ortopedia polska.

[13]  K. Trieb,et al.  In vivo and in vitro Cellular Ingrowthinto a New Generation of Artificial Ligaments , 2004, European Surgical Research.

[14]  H. Tohyama,et al.  Clinical evaluation of anatomic double-bundle anterior cruciate ligament reconstruction procedure using hamstring tendon grafts: comparisons among 3 different procedures. , 2006, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[15]  Lavoie,et al.  Patient satisfaction needs as related to knee stability and objective findings after ACL reconstruction using the LARS artificial ligament. , 2000, The Knee.

[16]  J. Karlsson,et al.  Patellar tendon or semitendinosus tendon autografts for anterior cruciate ligament reconstruction: a prospective, randomized study with a 7-Year follow-up. , 2003, The American journal of sports medicine.

[17]  D. Deehan,et al.  A Five-Year Comparison of Patellar Tendon versus Four-Strand Hamstring Tendon Autograft for Arthroscopic Reconstruction of the Anterior Cruciate Ligament , 2002, The American journal of sports medicine.

[18]  K. Webster,et al.  Early post-operative morbidity following anterior cruciate ligament reconstruction: patellar tendon versus hamstring graft , 2001, Knee Surgery, Sports Traumatology, Arthroscopy.

[19]  J. Bullock-Saxton,et al.  Muscle strength and function before and after anterior cruciate ligament reconstruction using semitendonosus and gracilis. , 2001, The Knee.

[20]  T. Wredmark,et al.  A comparison of quadruple semitendinosus and patellar tendon grafts in reconstruction of the anterior cruciate ligament. , 2001, The Journal of bone and joint surgery. British volume.

[21]  M. D. Shaieb,et al.  A Prospective Randomized Comparison of Patellar Tendon versus Semitendinosus and Gracilis Tendon Autografts for Anterior Cruciate Ligament Reconstruction * , 2002, The American journal of sports medicine.

[22]  F. Rayan,et al.  Clinical, MRI, and arthroscopic correlation in meniscal and anterior cruciate ligament injuries , 2009, International Orthopaedics.

[23]  J. Bullock-Saxton,et al.  Strength and Function Before and After Anterior Cruciate Ligament Reconstruction , 2000, Clinical orthopaedics and related research.

[24]  Liu Yang,et al.  Roentgenographic measurement study for locating femoral insertion site of anterior cruciate ligament: a cadaveric study with X-Caliper , 2009, International Orthopaedics.

[25]  J. Fernandes,et al.  Knee dislocations: experience at the Hôpital du Sacré-Coeur de Montréal. , 2004, Canadian journal of surgery. Journal canadien de chirurgie.

[26]  J. Kartus,et al.  Patellar Tendon or Semitendinosus Tendon Autografts for Anterior Cruciate Ligament Reconstruction , 2007, The American journal of sports medicine.

[27]  J. Sandelin,et al.  A Prospective Randomized Study of Patellar versus Hamstring Tendon Autografts for Anterior Cruciate Ligament Reconstruction , 2003, The American journal of sports medicine.