The Introduction of an Artificial Ligament for Reconstruction of the Anterior Cruciate Ligament: A Department's Critical Review of Complications and Problems

Abstract

Background: We reviewed the results of anterior cruciate ligament reconstruction using the Ligament Advanced Reinforcement System (LARS). The aim of the study was to analyze the outcome. Methods: From 2000 to 2002 26 patients with an acute rupture of the anterior cruciate ligament were operated using the LARS ligament and underwent a routine examination at a minimum of one year after surgery. The follow-up sheets of these clinical controls were analyzed. Results: Eleven patients (42.3 %) required a reoperation. Another seven patients (27 %) complained either of massive loss of flexion, extension deficit, persistent pain or persisting anterior knee instability with giving way attacks, however, they declined to undergo a reoperation. Two infections occurred (8 %). This left us with a 69 % rate of postoperative problems and complications. Another four patients (15.4 %) had knee laxity (Lachmann positive), but no subjective instability problems. Conclusion: The main reason for this high rate of complications might be the inhomogeneous group of nine different surgeons with varying levels of experience. The complication rate also represents the learning curve of the unit. However, we do not suggest using this artificial ligament for routine operations of the anterior cruciate ligament due to the high rate of postoperative problems and complications.

Key words

anterior cruciate ligament - reconstruction - synthetic augmentation - knee - arthroscopy

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