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Archives of Orthopaedic and Trauma Surgery

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01-12-2014 | Arthroscopy and Sports Medicine

Hamstring tendon autograft versus LARS artificial ligament for arthroscopic posterior cruciate ligament reconstruction in a long-term follow-up

Authors: Xinxian Xu, Tingting Huang, Zhongtang Liu, Hong Wen, Luyou Ye, Yuezheng Hu, Huachen Yu, Xiaoyun Pan

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 12/2014

Abstract

Introduction

Surgical reconstruction has been increasingly recommended for the surgical management of posterior cruciate ligament (PCL) ruptures. While the choice of tissue graft still remains controversial. Currently both hamstring tendon autograft (HTG) and ligament advanced reinforcement system (LARS) artificial ligament are widely used but there are seldom reports on the comparisons of their clinical results. Our study was aimed to assess the effectiveness of these two grafts.

Materials and methods

Thirty-five patients with unilateral PCL rupture were enrolled in this retrospectively study. Sixteen of them received arthroscopically assisted PCL reconstruction using hamstring tendon autografts (HTG group) and nineteen using LARS ligaments (LARS group). All cases were followed up for 46–57 months with a mean of 51 months. Follow-up examinations included radiographic assessment, Lysholm score, Tegner score, International Knee Documentation Committee (IKDC) rating scales and KT-1000 test.

Results

All patients improved significantly at the final follow-up compared with the examinational results preoperatively and there were no significant differences between HTG group and LARS group with respect to the results of radiographic assessment, Lysholm score, Tegner score, IKDC rating scales and KT-1000 test.

Conclusions

Similar good clinical results were obtained after PCL reconstruction using hamstring tendon autografts and LARS ligaments. Both LARS ligament and hamstring tendon autograft are ideal grafts for PCL reconstruction.

Shen G, Xu Y, Dong Q et al (2012) Arthroscopic posterior cruciate ligament reconstruction using LARS artificial ligament: a retrospective study. J Surg Res 173(1):75–82PubMedCrossRef

Shino K, Horibe S, Nakata K et al (1995) Conservative treatment of isolated injuries to the posterior cruciate ligament in athletes. J Bone Joint Surg Br 77:895–900PubMed

Zorzi C, Alam M, Iacono V et al (2013) Combined PCL and PLC reconstruction in chronic posterolateral instability. Knee Surg Sports Traumatol Arthrosc 21(5):1036–1042PubMedCrossRef

Lee DC, Shon OJ, Park CH et al (2011) A Clinical and Radiographic Comparison of Anteromedial and Anterolateral Trans-tibial PCL Reconstruction. J Korean Orthop Assoc 46(5):419–425CrossRef

Shah NV (2013) Posterior Cruciate Ligament (PCL) Injuries in Children: long term follow up of 20 cases of reconstruction and repair. Arthrosc J Arthrosc Relat Surg 29(10):e103–e104CrossRef

Lin YC, Chen SK, Liu TH et al (2013) Arthroscopic transtibial single-bundle posterior cruciate ligament reconstruction using patellar tendon graft compared with hamstring tendon graft. Arch Orthop Trauma Surg 133(4):523–530PubMedCrossRef

Jenner JM, van der Hart CP, Willems WJ (2006) Mid-term results of arthroscopic reconstruction in chronic posterior cruciate ligament instability. Knee Surg Sports Traumatol Arthrosc 14:848PubMedCrossRef

Hoher J, Scheffler S, Weiler A (2003) Graft choice and graft fixation in PCL reconstruction. Knee Surg Sports Traumatol Arthrosc 11:297PubMedCrossRef

Aune AK, Holm I, Risberg MA et al (2001) Four-strand hamstring tendon autograft compared with patellar tendon-bone autograft for anterior cruciate ligament reconstruction a randomized study with two-year follow-up. Am J sports med 29(6):722–728PubMed

10.

Marumo K, Saito M, Yamagishi T et al (2005) The ‘‘ligamentization’’ process in human anterior cruciate ligament reconstruction with autogenous patellar and hamstring tendons: a biochemical study. Am J Sports Med 33:1166PubMedCrossRef

11.

Dürselen L, Hehl G, Simnacher M et al (2001) Augmentation of a ruptured posterior cruciate ligament provides normal knee joint stability during ligament healing. Clin Biomech (Bristol, Avon) 16:222CrossRef

12.

Trieb K, Blahovec H, Brand G et al (2004) In vivo and in vitro cellular in-growth into a new generation of artificial ligaments. Eur Surg Res 36:148PubMedCrossRef

13.

Machotka Z, Scarborough I, Duncan W et al (2010) Anterior cruciate ligament repair with LARS (ligament advanced reinforcement system): a systematic review. BMC Sports Sci, Med Rehabil 2(1):29

14.

Gao K, Chen S, Wang L et al (2010) Anterior cruciate ligament reconstruction with LARS artificial ligament: a multicenter study with 3- to 5-year follow-up. Arthrosc J Arthrosc Relat Surg 26(4):515–523CrossRef

15.

Salim R, Fogagnolo F, Kfuri M 2013 A new simplified Onlay technique for posterior cruciate ligament reconstruction. J Knee Surg. (EFirst)

16.

Bray RC, Leonard CA, Salo PT (2002) Vascular physiology and long-term healing of partial ligament tears. J Orthop Res 20(5):984–989PubMedCrossRef

17.

Hartnett N, Feller JA, Leigh W et al (2013) Fifteen year follow-up of a randomised comparison of patellar tendon and hamstring tendon anterior cruciate ligament reconstruction. Arthroscopy 29(10):e143–e144CrossRef

18.

Herbort M, Tecklenburg K, Zantop T et al (2013) Single-bundle anterior cruciate ligament reconstruction: a biomechanical cadaveric study of a rectangular quadriceps and bone-patellar tendon–bone graft configuration versus a round hamstring graft. Arthrosc J Arthrosc Relat Surg 29(12):1981–1990CrossRef

19.

Sofu H, Sahin V, Gürsu S et al (2013) Use of quadriceps tendon versus hamstring tendon autograft for arthroscopic anterior cruciate ligament reconstruction: a comparative analysis of clinical results. Joint dis relat surg (Eklem hastalıkları ve cerrahisi) 24(3):139CrossRef

20.

Chen CH, Chen WJ, Shih CH (2002) Arthroscopic reconstruction of the posterior cruciate ligament: a comparison of quadriceps tendon autograft and quadruple hamstring tendon graft. Arthroscopy 18:603–612PubMedCrossRef

21.

Shelton WR, Papendick L, Dukes AD (1997) Autograft versus allograft anterior ligament reconstruction. Arthroscopy 13:446–449PubMedCrossRef

22.

Wang CJ, Chen HS, Huang TW (2003) Outcome of arthroscopic single bundle reconstruction for complete posterior cruciate ligament tear. Injury 34(10):747–751PubMedCrossRef

23.

Hatayama K, Higuchi H, Kimura M et al (2006) A comparison of arthroscopic single-and double-bundle posterior cruciate ligament reconstruction: review of 20 cases. Am J orthop (Belle Mead, NJ) 35(12):568–571

24.

Fanelli GC, Beck JD, Edson CJ (2012) Single compared to double-bundle PCL reconstruction using allograft tissue. J Knee Surg 25(1):059CrossRef

25.

Yasuda K, Kondo E, Ichiyama H et al (2004) Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. Arthroscopy 20:1015–1025PubMedCrossRef

26.

Zhao J, Peng X, He Y et al (2006) Two- bundle anterior cruciate ligament reconstruction with eight-stranded hamstring tendons: four-tunnel technique. Knee 13:36–41PubMedCrossRef

27.

Mae T, Shino K, Miyama T et al (2001) Single- versus two- femoral socket anterior cruciate ligament reconstruction technique: biomechanical analysis using a robotic simulator. Arthroscopy 17:708–716PubMedCrossRef

28.

Chan YS, Yang SC, Chang CH et al (2006) Arthroscopic reconstruction of the posterior cruciate ligament with use of a quadruple hamstring tendon graft with 3-to 5-year follow-up. Arthrosc J Arthrosc Relat Surg 22(7):762–770CrossRef

29.

Chen CP, Lin YM, Chiu YC et al (2012) Outcomes of arthroscopic double-bundle pcl reconstruction using the LARS artificial ligament. Orthopedics 35(6):458CrossRef

30.

Li B, Wen Y, Wu H et al (2009) Arthroscopic single-bundle posterior cruciate ligament reconstruction: retrospective review of hamstring tendon graft versus LARS artificial ligament. Int Orthop 33(4):991–996PubMedCentralPubMedCrossRef

31.

Huang JM, Wang Q, Shen F et al (2010) Cruciate ligament reconstruction using LARS artificial ligament under arthroscopy: 81 cases report. Chin Med J (Engl) 123:160

32.

Yu S, Dong Q, Wang Y et al (2008) Histological characteristics and ultrastructure of polyethylene terephthalate LARS ligament following the reconstruction of anterior cruciate ligament in rabbits. J Clin Rehabil Tissue Eng Res 12(36):7061–7066

33.

Janssen RPA, Scheffler SU (2013) Intra-articular remodelling of hamstring tendon grafts after anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy, 1–7

34.

Fujimoto E, Sumen Y, Urabe Y et al (2004) An early return to vigorous activity may destabilize anterior cruciate ligaments reconstructed with hamstring grafts. Arch Phys Med Rehabil 85(2):298–302PubMedCrossRef

35.

Menetrey J, Duthon VB, Laumonier T et al (2008) “Biological failure” of the anterior cruciate ligament graft. Knee Surg Sports Traumatol Arthrosc 16(3):224–231PubMedCrossRef

Title: Hamstring tendon autograft versus LARS artificial ligament for arthroscopic posterior cruciate ligament reconstruction in a long-term follow-up
Authors: Xinxian Xu
Tingting Huang
Zhongtang Liu
Hong Wen
Luyou Ye
Yuezheng Hu
Huachen Yu
Xiaoyun Pan
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 12/2014
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-014-2104-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hamstring tendon autograft versus LARS artificial ligament for arthroscopic posterior cruciate ligament reconstruction in a long-term follow-up

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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