A COMPARISON OF EFFECTIVENESS BETWEEN LIGAMENT ADVANCED REINFORCEMENT SYSTEM AND BONE-PATELLAR TENDON-BONE AUTOGRAFT FOR ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Yecheng ^1,2 , ZHANG Wei ³ , WU Yong ¹ , WANG Hongjun ¹ , KANG Long ¹ , HU Mianhu ¹ , CHEN Genyuan ² , ZHU Baolin ¹

1Department of Orthopedics, 3Laboratory Department, Hospital of Shuyang, Shuyang Jiangsu, 223600, P.R.China;;
2Department of Orthopedics, First Affiliated Hospital of Lanzhou University. Corresponding author: ZHU Baolin, E-mail: 312621691@qq.com;

Corresponding author：

Keywords：

Anterior cruciate ligament injury; Ligament advanced reinforcement system; Autogenous bone-patellar tendon-bone; Ligament reconstruction

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ObjectiveTo compare the effectiveness of anterior cruciate ligament (ACL) reconstruction between the ligament advanced reinforcement system (LARS) and bone-patellar tendon-bone (BPTB) autograft. MethodsBetween July 2007 and July 2011, 50 cases (50 knees) of ACL injury were treated with LARS in 24 cases (LARS group) and with BPTB in 26 cases (BPTB group), respectively. There was no significant difference in age, gender, time from injury to surgery, and injury reason between BPTB group and LARS group (P gt; 0.05). The postoperative rehabilitation protocol was performed in 2 groups. ResultsAll incisions healed at the first stage. All patients were followed up 2-3 years. The results of Lachman test, anterior drawer test, and pivot shift test were negative. Screw loosening in femur and tibia occurred in 1 case of each group respectively, anterior knee pain in 2 cases of BPTB group and in 1 case of LARS group. The Lysholm and Tegner scores were significantly higher in LARS group than in BPTB group at 2 and 6 months after operation (P lt; 0.05); but no significant difference was found between 2 groups at 12 and 24 months (P gt; 0.05). The IKDC scores showed no significant difference between 2 groups at different time points after operation (P gt; 0.05). During follow up, KT-1000 arthrometer and knee stability showed significant differences in antedisplacements of the tibia between 2 groups at all time points after operation (P lt; 0.05). ConclusionLARS has less trauma and earlier functional recovery than BPTB autograft for ACL reconstruction, but the long-term effectiveness is similar.

Citation： LI Yecheng,ZHANG Wei,WU Yong,WANG Hongjun,KANG Long,HU Mianhu,CHEN Genyuan,ZHU Baolin. A COMPARISON OF EFFECTIVENESS BETWEEN LIGAMENT ADVANCED REINFORCEMENT SYSTEM AND BONE-PATELLAR TENDON-BONE AUTOGRAFT FOR ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(9): 1045-1050. doi: Copy

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2.	Li B, Wen Y, Wu H, et al. Arthroscopic single-bundle posterior cruciate ligament reconstruction: retrospective review of hamstring tendon graft versus LARS artificial ligament. Int Orthop, 2009, 33(4): 991-996.
3.	Fellar JA, Webster KE, Gavin B. Early post-operative morbidity following anterior cruciate ligament reconstruction: patellar tendon versus hamstring graft. Knee Surg Sports Traumatol Arthrosc, 2001, 9(5): 260-266.
4.	Lavoie P, Fletcher J, Duval N. Patient satisfaction needs as related to knee stability and objective findings after ACL reconstruction using LARS artificial ligament. Knee, 2000, 7(3): 157-163.
5.	Trieb K, Blahovec H, Brand G, et al. In vivo and in vitro cellular ingrowth into a new generation of artificial ligaments. Eur Surg Res, 2004, 36(3): 148-151.
6.	Gao K, Chen S, Wang L, et al. Anterior cruciate ligament reconstruction with LARS artificial ligament: a multicenter study with 3- to 5-year follow-up. Arthroscopy, 2010, 26(4): 515-523.
7.	Hefti F, Müller W, Jakob RP, et al. Evaluation of knee ligament injuries with the IKDC form. Knee Surg Sports Traumatol Arthrosc, 1993, 1(3-4): 226-234.
8.	Bartlett RJ, Clatworthy MG, Nguyen TN. Graft selection in reconstruction of the anterior cruciate ligament. J Bone Joint Surg (Br), 2001, 83(5): 625-634.
9.	Feagin JA Jr, Wills RP, Lambert KL, et al. Anterior cruciate ligament reconstruction. Bone-patella tendon-bone versus semitendinosus anatomic reconstruction. Clin Orthop Relat Res, 1997, (341): 69-72.
10.	Marder RA, Raskind JR, Carroll M. Prospective evaluation of arthroscopically assisted anterior cruciate ligament reconstruction. Patellar tendon versus semitendinosus and gracilis tendions. Am J Sports Med, 1991, 19(5): 478-484.
11.	李鑫, 田金徽, 杨克虎, 等. 可吸收螺钉和金属挤压螺钉比较重建前交叉韧带的Meta分析. 中国循证医学杂志, 2010, 10(7): 848-856.
12.	Nau T, Lavoie P, Duval N. A new generation of artificial ligaments in reconstruction of the anterior cruciate ligament. Two-year follow-up of a randomized trial. J Bone Joint Surg (Br), 2002, 84(3): 356-360.
13.	平安松, 顾洁夫, 王欣, 等. 带骨瓣的髌腱中1/3 重建前交叉韧带. 中国修复重建外科杂志, 2000, 14(2): 72-73.

1. Feagin JA Jr, Curl WW. Isolated tear of the anterior cruciate ligament: 5-year follow-up study. Am J Sports Med, 1976, 4(3): 95-100.
2. Li B, Wen Y, Wu H, et al. Arthroscopic single-bundle posterior cruciate ligament reconstruction: retrospective review of hamstring tendon graft versus LARS artificial ligament. Int Orthop, 2009, 33(4): 991-996.
3. Fellar JA, Webster KE, Gavin B. Early post-operative morbidity following anterior cruciate ligament reconstruction: patellar tendon versus hamstring graft. Knee Surg Sports Traumatol Arthrosc, 2001, 9(5): 260-266.
4. Lavoie P, Fletcher J, Duval N. Patient satisfaction needs as related to knee stability and objective findings after ACL reconstruction using LARS artificial ligament. Knee, 2000, 7(3): 157-163.
5. Trieb K, Blahovec H, Brand G, et al. In vivo and in vitro cellular ingrowth into a new generation of artificial ligaments. Eur Surg Res, 2004, 36(3): 148-151.
6. Gao K, Chen S, Wang L, et al. Anterior cruciate ligament reconstruction with LARS artificial ligament: a multicenter study with 3- to 5-year follow-up. Arthroscopy, 2010, 26(4): 515-523.
7. Hefti F, Müller W, Jakob RP, et al. Evaluation of knee ligament injuries with the IKDC form. Knee Surg Sports Traumatol Arthrosc, 1993, 1(3-4): 226-234.
8. Bartlett RJ, Clatworthy MG, Nguyen TN. Graft selection in reconstruction of the anterior cruciate ligament. J Bone Joint Surg (Br), 2001, 83(5): 625-634.
9. Feagin JA Jr, Wills RP, Lambert KL, et al. Anterior cruciate ligament reconstruction. Bone-patella tendon-bone versus semitendinosus anatomic reconstruction. Clin Orthop Relat Res, 1997, (341): 69-72.
10. Marder RA, Raskind JR, Carroll M. Prospective evaluation of arthroscopically assisted anterior cruciate ligament reconstruction. Patellar tendon versus semitendinosus and gracilis tendions. Am J Sports Med, 1991, 19(5): 478-484.
11. 李鑫, 田金徽, 杨克虎, 等. 可吸收螺钉和金属挤压螺钉比较重建前交叉韧带的Meta分析. 中国循证医学杂志, 2010, 10(7): 848-856.
12. Nau T, Lavoie P, Duval N. A new generation of artificial ligaments in reconstruction of the anterior cruciate ligament. Two-year follow-up of a randomized trial. J Bone Joint Surg (Br), 2002, 84(3): 356-360.
13. 平安松, 顾洁夫, 王欣, 等. 带骨瓣的髌腱中1/3 重建前交叉韧带. 中国修复重建外科杂志, 2000, 14(2): 72-73.

Chinese Journal of Reparative and Reconstructive Surgery

A COMPARISON OF EFFECTIVENESS BETWEEN LIGAMENT ADVANCED REINFORCEMENT SYSTEM AND BONE-PATELLAR TENDON-BONE AUTOGRAFT FOR ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

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